The Effects of Risk Factors on Recovery of Elderly Patients With Atrial Fibrillation After Non-cardiac Surgery

Background: and Objective: Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. However, no literature has reported the correlation between the quality of recovery of AF patients after non-cardiac surgery and their preoperative basic and intraoperative conditions. The present study aimed to screen factors that affect recovery of AF patients after non-cardiac surgery. Methods: : 120 patients with AF who aged ≥ 60 years old and scheduled to undergo non-cardiac surgery were included. The patients were divided into two groups according to the score of quality of recovery-15 (QoR-15) at 120 h after surgery, which were 122-150 points (satisfactory recovery, group A) and 0-121 points (poor recovery, group B). Their preoperative basic conditions (age, co-existing disease, mean ventricular rate, anticoagulant therapy, etc.), intraoperative conditions (the anesthesia satisfaction scale), and the QoR-15 scores after the surgery were recorded. Besides, the levels of plasma brain natriuretic peptide (BNP), high-sensitivity cardiac troponin (hs-cTn), and presepsin (soluble cluster-of-differentiation 14 subtype [sCD14-ST]) before and after surgery were measured. The data were analyzed to screen factors, influencing the postoperative recovery of patients with AF after non-cardiac surgery. Results: : The independent risk factors for elderly patients with AF after non-cardiac surgery were mean ventricular rate (odds ratio (OR): 1.085; 95% confidence interval (CI): 1.040-1.131; P<0.001), high-risk surgery (OR: 0.185; 95% CI: 0.043-0.798; P=0.024), and anesthesia satisfaction scale score (OR: 2.392; 95% CI: 1.524-3.753; P<0.001). In the anesthesia satisfaction scale, hypotension (P=0.005), tachycardia/bradycardia (P=0.021), blood transfusion (P=0.047), and RASS score (P=0.041) were also found as risk factors for recovery. The levels of BNP and hs-cTn can be helpful to predict the prognosis in patients with AF. Conclusion: Poorly controlled ventricular rate, high-risk surgery, and high score of anesthesia satisfaction scale can affect the prognosis in elderly patients with AF undergoing non-cardiac surgery. The levels of BNP and hs-cTn may correlate with early recovery of such patients.