# Short- and Long-Term Outcomes of Patients with Postoperative Arrhythmia after Liver Surgery

## TL;DR

This study finds that new-onset arrhythmia after liver surgery is rare but linked to worse outcomes and higher mortality.

## Contribution

The study is the first to analyze the incidence and impact of postoperative arrhythmia specifically after liver surgery.

## Key findings

- Postoperative arrhythmia occurred in 5.4% of liver surgery patients.
- Arrhythmia was linked to intraoperative complications, liver disease, and organ failure.
- Patients with arrhythmia had significantly worse long-term survival.

## Abstract

Background: New-onset postoperative arrhythmia (PA) has previously been described as a pivotal risk factor for postoperative morbidity and mortality after visceral surgery. However, there is a lack of data concerning liver surgery. The incidence and impact of new-onset postoperative arrhythmia after liver surgery was, therefore, analyzed in a monocentric study. Methods: In total, n = 460 patients (221 female, 239 male) who underwent liver surgery between January 2012 and April 2020 without any prior arrhythmia in their medical history were included in this retrospective analysis. Clinical monitoring started with the induction of anesthesia and was terminated with discharge from the intensive care unit (ICU) or intermediate care unit (IMC). Follow-up included documentation of complications during the hospital stay, as well as long-term survival analysis. Results: Postoperative arrhythmia after liver surgery was observed in 25 patients, corresponding to an incidence of 5.4%. The occurrence of arrhythmia was significantly associated with intraoperative complications (p < 0.05), liver fibrosis/cirrhosis (p < 0.05), bile fistula/bile leakage/bilioma (p < 0.05), and organ failure (p < 0.01). Survival analysis showed a significantly poorer overall survival of patients who developed postoperative arrhythmia after liver surgery (p < 0.001). Conclusions: New-onset postoperative arrhythmia after liver surgery has an incidence of only 5.4% but is significantly associated with higher postoperative morbidity and poorer overall survival.