title: Incidence and implications of postoperative supraventricular tachycardia after pulmonary lobectomy.
abstract: OBJECTIVE
  We sought to determine the rate of postoperative supraventricular tachycardia (POSVT) in patients undergoing pulmonary lobectomy, and its association with adverse outcomes.
  
  
  METHODS
  Using the State Inpatient Database, from the Healthcare Cost and Utilization Project, we reviewed lobectomies performed (2009-2011) in California, Florida, and New York, to determine POSVT incidence. Patients were grouped by presence or absence of POSVT, with or without other complications. Stroke rates were analyzed independently from other complications. Multivariable regression analysis was used to determine factors associated with POSVT.
  
  
  RESULTS
  Among 20,695 lobectomies performed, 2449 (11.8%) patients had POSVT, including 1116 (5.4%) with isolated POSVT and 1333 (6.4%) with POSVT with other complications. Clinical predictors of POSVT included age ≥75 years, male gender, white race, chronic obstructive pulmonary disease, congestive heart failure, thoracotomy surgical approach, and pulmonary complications. POSVT was associated with an increase of: stroke (odds ratio [OR] 1.74; 95% confidence interval [CI] 1.03-2.94); in-hospital death (OR 1.85; 95% CI 1.45-2.35); LOS (OR 1.33; 95% CI 1.29-1.37); and readmission (OR 1.29; 95% CI 1.04-1.60). The stroke rate was <1% in patients who had isolated POSVT, and 1.5% in patients with POSVT with other complications. Patients with isolated POSVT had increased readmission and LOS, and a marginal increase in stroke rate, compared with patients with an uncomplicated course.
  
  
  CONCLUSIONS
  POSVT is common in patients undergoing pulmonary lobectomy and is associated with adverse outcomes. Comparative studies are needed to determine whether strict adherence to recently published guidelines will decrease the rate of stroke, readmission, and death after POSVT in thoracic surgical patients.
authors.affiliation: Department of Anesthesiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Giambrone
authors.affiliation: Department of Healthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY.
authors.forename: Xian
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
authors.forename: Licia K
authors.initials: LK
authors.lastname: Gaber-Baylis
authors.affiliation: Department of Computer Science, Cornell University, Ithaca, NY.
authors.forename: Akshay U
authors.initials: AU
authors.lastname: Bhat
authors.affiliation: Department of Computer Science, Cornell University, Ithaca, NY.
authors.forename: Ramin
authors.initials: R
authors.lastname: Zabih
authors.affiliation: Department of Cardiothoracic Surgery, Thoracic Division, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
authors.forename: Nasser K
authors.initials: NK
authors.lastname: Altorki
authors.affiliation: Department of Anesthesiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Fleischut
authors.affiliation: Department of Cardiothoracic Surgery, Thoracic Division, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY. Electronic address: brs9035@med.cornell.edu.
authors.forename: Brendon M
authors.initials: BM
authors.lastname: Stiles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: postoperative supraventricular tachycardia; pulmonary lobectomy