• Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, P. R. China S1Juan and LIU Xiaolong were the co-first authors;
YUAN Ligong, Email: yligong@ustc.edu.cn
Export PDF Favorites Scan Get Citation

Objective  To analyze the risk factors affecting the occurrence of arrhythmia after esophageal cancer surgery, construct a risk prediction model, and explore its clinical value. Methods  A retrospective analysis was conducted on the clinical data of patients who underwent radical esophagectomy for esophageal cancer in the Department of Thoracic Surgery at Anhui Provincial Hospital from 2020 to 2023. Univariate and multivariate analyses were used to screen potential factors influencing postoperative arrhythmia. A risk prediction model for postoperative arrhythmia was constructed, and a nomogram was drawn. The predictive performance of the model was then validated. Results  A total of 601 esophageal cancer patients were randomly divided into a modeling group (421 patients) and a validation group (180 patients) at a 7:3 ratio. In the modeling group, patients were further categorized into an arrhythmia group (188 patients, 44.7%) and a non-arrhythmia group (233 patients, 55.3%) based on whether they developed postoperative arrhythmia. Among those with postoperative arrhythmia, 43 (10.2%) patients had atrial fibrillation (AF), 12 (2.9%) patients had atrial premature beats, 15 (3.6%) patients had sinus bradycardia, and 143 (34%) patients had sinus tachycardia. Some patients exhibited multiple arrhythmias, including 14 patients with AF combined with sinus tachycardia, 7 patients with AF combined with atrial premature beats, and 3 patients with AF combined with sinus bradycardia. Univariate analysis revealed that a history of hypertension, heart disease, pulmonary infection, acute respiratory distress syndrome, postoperative hypoxia, anastomotic leakage, and delirium were risk factors for postoperative arrhythmia in esophageal cancer patients (P<0.05). Multivariate logistic regression analysis showed that a history of heart disease, pulmonary infection, and postoperative hypoxia were independent risk factors for postoperative arrhythmia after esophageal cancer surgery (P<0.05). The area under the receiver operating characteristic curve (AUC) of the constructed risk prediction model for postoperative arrhythmia was 0.710 [95% CI (0.659, 0.769)], with a sensitivity of 0.617 and a specificity of 0.768. Conclusion  A history of heart disease, pulmonary infection, and postoperative hypoxia are independent risk factors for postoperative arrhythmia after esophageal cancer surgery. The risk prediction model constructed in this study can effectively identify high-risk patients for postoperative arrhythmia, providing a basis for personalized interventions.

Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved