Hu et al reported predictors for perioperative atrial fibrillation in burn patients. These can help to identify a patient who may require more aggressive management. The authors are from Guangzhou Red Cross Hospital and Jinan University in China.
Patient selection: burn patient in ICU in perioperative period
Most cases of perioperative atrial fibrillation occur on the day of surgery.
The risk was greater if surgery was performed within 2 weeks of burn injury.
Predictors of atrial fibrillation on multivariate analysis:
(1) percent total burn surface area (OR 13.9, with median 80% vs 60% without AF)
(2) percent surface area with third degree burns (OR 15.2, with median 60% vs 45% without AF)
Hypertension had an OR of 10.8 with p value of 0.067.
Factors that may contribute to risk:
(1) hypothermia (< 35°C)
(2) hypoxia (PaO2 < 60 mm Hg)
(3) pH < 7.25
(4) serum magnesium < 0.75 mmol/L
(5) serum potassium < 3.0 mmol/L
(6) postoperative anemia with hemoglobin < 80 g/L
(7) acute hemorrhage with hypovolemia
(8) therapy with vasopressors
(9) sepsis or positive blood cultures
(10) pulmonary edema
