Original articleGeneral thoracicRisk Factors for Atrial Fibrillation After Lung Cancer Surgery: Analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database
Section snippets
The STS National General Thoracic Surgery Database
The STS National General Thoracic Surgery Database (GTSD) is a voluntary database that was initiated in 1999, and reports began to be issued in 2002. At the time of the last report (November 2009), there were 111 participants. Harvests and reports are made semianually to provide participants with their risk-adjusted outcomes compared with the national experience. Harvested data are maintained and analyzed by the Duke Clinical Research Institute in compliance with the Health Insurance
Baseline Features and Outcomes
A total of 14,041 patients met criteria for the study. Of these, 13,906 had complete information regarding the outcome of atrial arrhythmia after surgery. Of those patients, 1,755 (12.6%) developed an atrial arrhythmia before discharge from the hospital. Table 1 demonstrates the demographic characteristics of the entire cohort. As expected, the patients were elderly smokers with the usual range of comorbidities. Pulmonary function was generally good, and the vast majority of patients were early
Comment
We sought to use the STS GTSD to identify risk factors for atrial arrhythmia after lobectomy or greater for primary lung cancer. Our multivariable model identified increasing age, increasing extent of operation, male sex, nonblack race, and clinical stage II or greater tumors as predictive of postoperative atrial arrhythmia. A reduced model containing these five variables allows stratification of patients into high-risk categories for possible future trial of pharmacologic prophylaxis.
Strengths
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