The Analysis Of Risk Factors And Prediction Of Postoperative Arrhythmia In Elderly Patients With Esophageal Cancer Above 65 Years Old

ObjectiveTo study the risk factors of postoperative arrhythmia in?65 year old patients with esophageal cancer,prevent and deal with the occurrence of arrhythmia,and improve the safety of perioperative period.and predict the possibility of arrhythmia after operation.MethodsA retrospective analysis of the 219 patients?65 year old esophageal cancer who underwent surgery in our hospital from january 1,2017 to january 1,2019.the risk factors that may affect postoperative arrhythmia were analyzed,including:age,sex,smoking,alcohol consumption,hypertension,diabetes mellitus,preoperative cardiac insufficiency,preoperative complicated arrhythmia,preoperative PO2<60 mmHg?intraoperative bleeding,operation time,operation method,number of lymph node dissection,tumor TNM staging,tumor site and other 15 indicators were independent variables,and there were no-action dependent variables for postoperative arrhythmia.The first one-factor analysis was carried out,then the multivariate Logistic regression analysis was carried out,and the probability prediction model of arrhythmia after operation was established,and draw the Nomogram map.ResultsThere were 71(32.42%)new arrhythmia after operation,including 32(45.07%)AF,28(39.44%)sinus tachycardia,10(14.08%)sinus bradycardia and 1(1.41%)ventricular premature beats.The results of single factor analysis showed that preoperative arrhythmia,preoperative cardiac insufficiency,operation time,number of lymph node dissection,tumor TNM stage P=0.021,0.007,0.001,<0001,0.006.The P of other observation indexes>0.05.The results of multivariate analysis showed that preoperative arrhythmia,preoperative cardiac insufficiency,operation time,number of lymph node dissection,tumor TNM stage P=0.031,0.011,0.043,0.016,0.024,OR=2.443,8.764,1.006,1.064,1.632.Logistic regression equation:P=ex/(1+e x),e was the base of natural logarithm,X=2.44+(0.893× preoperative with arrhythmia)+(2.171×preoperative cardiac insufficiency)+(0.006×operative time)+(0.062×number of lymph node dissection)+(0.49× tumor stage).The area under the receiver operating characteristic curve was 0.71,and the diagnostic efficiency was wellConclusionArrhythmia in patients with preoperative and arrhythmia is 2.443 times that in patients without arrhythmia.The longer the operation time,the more patients with lymph node dissection and the stage of tumor are more likely to have arrhythmia.For preoperative patients with arrhythmia or cardiac insufficiency,we should first control arrhythmia and cardiac insufficiency re-operation,the operation should also reduce the operation time,reduce bleeding,improve the perioperative safety of patients.