Risk index for peri-operative atrial fibrillation in patients undergoing open intracranial neurosurgical procedures.
The aim of this prospective study was to determine the prevalence of pre-operative atrial fibrillation and the incidence of postoperative atrial fibrillation in patients undergoing elective or emergency intracranial neurosurgical procedures and the relation to survival and neurological outcome at 6-months follow-up compared to patients with sinus rhythm. A total of 2020 patients were enrolled; 1540 patients underwent elective procedures and 480 underwent emergency procedures. Prevalence of pre-operative atrial fibrillation was 3.7% in elective and 7.2% in emergency procedures (p = 0.0012). In patients undergoing elective cerebral procedures with pre-operative atrial fibrillation, compared to patients with sinus rhythm, 6-month neurological outcome and survival rate are similar. In patients undergoing emergency neurosurgical cerebral procedures, the presence of pre-operative atrial fibrillation is related to an increased risk of poor neurological outcome but with similar survival rate.
Department of Anaesthesiology, Critical Care and Pain Medicine, La Sapienza University of Rome, Italy. bilotta@tiscali.it
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Bilotta
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Pizzichetta
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Fiorani
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Paoloni
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Delfini
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Rosa
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology; D004185:Disability Evaluation; D017558:Elective Surgical Procedures / Q000009:adverse effects; D004630:Emergencies; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000534:rehabilitation; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult