- Academic Editor
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†These authors contributed equally.
Background: Postoperative atrial fibrillation (POAF) is a common
complication that has shown conflicting results regarding sex differences. The
potential effect of age on this association has not been adequately explored.
We hypothesized that younger males would have a higher risk
of POAF than females and that this difference would vary by age group.
Methods: In this observational cohort study, we enrolled consecutive
patients who underwent non-cardiac surgery between January 2011 and June 2019 at
our institution and excluded those with preoperative atrial fibrillation and
those undergoing sex-specific surgery. We stratified the patients into four
groups based on their sex and age: females younger than 50 years, females older
than 50 years, males younger than 50 years, and males older than 50 years. The
primary outcome was the incidence of POAF. Results: Of the 141,337
patients included in the study, 6414 (4.5%) were treated for POAF. The incidence
of POAF was highest in males older than 50 years (7.4%), followed by females
older than 50 years (4.6%), males younger than 50 years (2.1%), and females
younger than 50 years (1.9%). After adjusting for potential confounding factors,
the risk of POAF was significantly increased in all groups compared with females
younger than 50 years, with an odds ratio (OR) of 2.43 (95% confidence interval
[CI]: 2.17–2.73, p