Analysis of risk factors for arrhythmia after esophageal cancer surgery and changes of cardiac troponin I and creatine kinase and uric acid

WANG Guo-fu; MA Li-Xin; XIA Jing; MU Yan-peng

doi:10.3969/j.issn.1672-5301.2025.07.013

Abstract：Objective To study the risk factors of arrhythmia after esophageal cancer surgery and the changes of troponin I,creatine kinase and uric acid.Methods In this retrospective study,100 patients undergoing esophageal cancer surgery at Jiamusi Central Hospital from June 2021 to March 2024 were selected as research objects,among which 25 patients developed arrhythmia within 72 hours after surgery.General data of patients with arrhythmia and non-arrhythmia after esophageal cancer surgery were analyzed respectively.To study the risk factors of postoperative arrhythmia in patients with esophageal cancer,the levels of cardiac troponin I,creatine kinase and uric acid were compared before surgery,1 day,3 day and 7 day after surgery.Result By comparing the general data of patients in the arrhythmia group and the non-arrhythmia group after esophageal cancer surgery,the age(t=20.161,P=0.000),body mass index(t=2.023,P=0.046),hypertension(χ2=5.289,P=0.022),diabetes(χ2=20.959,P=0.000),hyperlipidemia(χ2=7.692,P=0.006),coronary heart disease(χ2=7.692,P=0.001),forced vital capacity(FVC)(t=22.790,P=0.000),peakexpiratoryflow(PEF)(t=26.790,P=0.000),forced expiratory volume in one second(FEV1)(t=26.790,P=0.000),(FEV1/FVC)(t=95.937,P=0.000),preoperative cardiopulmonary disease(χ2=10.889,P=0.001),intraoperative blood loss(t=228.607,P=0.000),operative time(t=5.453,P=0.000),preoperative blood potassium(t=2.981,P=0.004),preoperative cardiac troponin I(t=3.841,P=0.000),preoperative creatine kinase(t=174.862,P=0.000),preoperative uric acid(t=18.443,P=0.000)and smoking index(χ2=10.214,P=0.001)were statistically significant(P<0.05).Age,body mass index,hypertension,diabetes,hyperlipidemia,coronary heart disease,FVC,PEF,FEV1,FEV1/FVC,preoperative cardiopulmonary disease,operative mode,intraoperative blood loss,operative time,preoperative blood potassium,preoperative myocardial troponin I,preoperative creatine kinase,preoperative uric acid,and smoking index were all risk factors for postoperative arrhythmia of esophageal cancer.Through model building,Arrhythmia risk after esophageal cancer surgery=-12.262+age×1.209+body mass index×1.218+hypertension×1.108+diabetes×1.117+hyperlipidemia×1.042+coronary heart disease×1.062+FVC×1.126+PEF×1.036+FEV1×1.182+FEV1/FVC×1.195+preoperative cardiopulmonary disease×1.197+operation method×1.185+intraoperative blood loss×1.116+operation time×1.139+preoperative serum potassium×1.084+preoperative cardiac troponin I×1.165+preoperative creatine kinase×1.026+preoperative uric acid×1.2+smoking index×1.139,Through the analysis of myocardial troponin I,creatine kinase and uric acid in patients with arrhythmia after esophageal cancer surgery at different time points,the myocardial troponin I,creatine kinase and uric acid in patients with arrhythmia after esophageal cancer surgery 1 and 3 days after surgery were significantly higher than those in patients with non-arrhythmia after esophageal cancer surgery.Although troponin I,creatine kinase and uric acid were significantly reduced in both groups,the levels of troponin I,creatine kinase and uric acid in patients with postoperative esophageal cancer arrhythmia were higher than those in patients without postoperative esophageal cancer arrhythmia.Conclusion Advanced age,high body mass index,combined hypertension/diabetes/hyperlipidemia/coronary heart disease,preoperative cardiopulmonary disease,poor lung function,large intraoperative blood loss,long operation time,preoperative hypokalemia,preoperative high cardiac troponin I,high creatine kinase,high uric acid and high smoking index are all independent risk factors for arrhythmia within 72 hours after esophageal cancer surgery.The established risk prediction model can quantitatively assess individual risks.