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Evaluating The Risks Of Preoperative Diabetes On Development Of Postoperative Atrial Fibrillation After Robotic-assisted Pulmonary Lobectomy
Sunny Kahlon1, Claire Dalby
1, Joseph R. Garrett
2, Carla C. Moodie
2, Katherine M. Dillen
2, Jenna R. Tew
2, Jobelle Joyce-Anne R. Baldonado
2, Jacques P. Fontaine
2, Eric M. Toloza
2;
1University of South Florida Health Morsani College of Medicine, Tampa, FL, USA,
2Moffitt Cancer Center, Tampa, FL, USA
BACKGROUND: Previous literature has suggested that diabetes mellitus is a risk factor for developing postoperative atrial fibrillation (POAF). The study examined whether diabetes and its related health complications heighten the risk of POAF after robotic-assisted video-thoracoscopic (RAVT) pulmonary lobectomy.
METHODS: This study retrospectively analyzed 655 patients without preoperative history of atrial fibrillation and who underwent RAVT lobectomy between September 2010 and August 2022 by the same surgeon. This study evaluated the presence of comorbidities, such as diabetes, coronary artery disease, heart failure, and kidney failure, among others, and the corresponding rates of POAF. Statistical analysis was performed using Chi-Square (X2), Fisher's exact test, and Student's t-test, with significance set at p≤0.05.
RESULTS: Out of 106 patients who had preoperative diabetes, 21 (19.8%) developed POAF after undergoing RAVT lobectomy. Diabetic patients had a higher risk of developing POAF (Odds Ratio [OR]=2.13; 95% confidence interval [CI]: 1.23-3.70; p=0.006) than Non-Diabetic patients. The mean age for Diabetic patients who developed POAF was 74.0 years versus 69.8 years for those who did not (p=0.03). Diabetic patients who developed POAF versus those without POAF did not differ in incidences of hypertension (p=0.98), hyperlipidemia (p=0.61), obesity (p=0.67), coronary artery disease (p=0.42), or cardiomyopathy (p=0.17). There was a trend of increased risk of developing POAF for Diabetic patients with chronic kidney disease, but the increase was not statistically significant (p=0.09). Smoking history, measured in pack-years, did not increase the risk of POAF; on average, those who developed POAF reported 51.6 pack-years, while patients without POAF had an average of 45.7 pack-years (p=0.60). No notable difference was found in the preoperative forced expiratory volume in 1 second as a percentage of predicted (FEV1%) between Diabetics who did and did not develop POAF (84.5% vs 85.2%; p=0.88).
CONCLUSIONS: Individuals with preoperative diabetes have an elevated risk of developing POAF following RAVT pulmonary lobectomy. However, common health complications often associated with diabetes, such as obesity, hyperlipidemia, and kidney disease, did not contribute to risk of POAF development.
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