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Adverse outcomes associated with postoperative atrial arrhythmias after lung transplantation: A meta‐analysis and systematic review of the literature
Author(s) -
Waldron Nathan H.,
Klinger Rebecca Y.,
Hartwig Matthew G.,
Snyder Laurie D.,
Daubert James P.,
Mathew Joseph P.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12926
Subject(s) - medicine , perioperative , lung transplantation , transplantation , meta analysis , surgery , adverse effect , cinahl , cochrane library , psychiatry , psychological intervention
Background Postoperative atrial arrhythmias (AAs) are common after lung transplantation, but studies are mixed regarding their impact on outcomes. We therefore performed this systematic review and meta‐analysis to determine whether AAs after lung transplantation impede postoperative recovery. Methods MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched to identify studies comparing outcomes in adult patients undergoing lung transplantation who experienced postoperative AAs in the immediate postoperative period vs those without postoperative AAs. Our primary outcome was perioperative mortality, and secondary outcomes were length of stay (LOS), postoperative complications, and mid‐term (1‐6 years) mortality. Results Nine studies including 2653 patients were included in this analysis. Of this group, 791 (29.8%) had postoperative AAs. Patients with postoperative AAs had significantly higher perioperative (OR 2.70 [95% CI: 1.73‐4.19], P <.0001) mortality, longer hospital LOS (MD 8.29 [95% CI: 4.37‐12.21] days, P <.0001), more frequent requirement for tracheostomy (OR 4.67 [95% CI: 2.59‐8.44], P <.0001), and higher mid‐term mortality (OR 1.71 [95% CI: 1.28‐2.30], P =.0003). Conclusions AAs after lung transplantation are frequent and associated with significantly higher mortality, longer hospital LOS, and requirement for tracheostomy. Given their impact on recovery, prophylactic strategies against AAs need to be developed.