Atrial fibrillation versus non-atrial fibrillation in postoperative complications following lumbar surgery: a retrospective case-control study

With an aging population and high prevalence rate of atrial fibrillation (AF) in older individuals, more elderly patients with AF receive lumbar operations. Nevertheless, there has been little study discussing the perioperative outcomes of AF in lumbar surgery, especially using a national database. A population-based, retrospective cohort survey was conducted on adults receiving lumbar surgery who were divided into 2 cohorts based on the diagnosis of AF or not, using the 2016–2019 Nationwide Inpatient Sample database. Propensity score matching was applied to eliminate selection bias. Univariate and multivariate analyses were performed to explore the impact of AF on postoperative complications following AF. Overall, 222,557 lumbar surgical patients were finally involved in the present study, 10,929 (4.9%) of whom had AF. Irrespective of potential confounders, the in-hospital death risk of patients undergoing lumbar surgery with AF was 1.75-fold compared to those without AF. Additionally, AF was an apparently independent risk factor for cardiac arrest, postoperative delirium, pneumonia, pulmonary embolism, acute respiratory failure, continuous trauma ventilation, acute renal failure, urinary tract infection, gastrointestinal bleeding, blood transfusion, pyemia, septicemia, death, wound infection, and hemorrhage/hematoma/seroma. AF seems to be associated with increased perioperative mortality and complications. Orthopedists should be cognizant of the adverse impact on patients with AF.