Sidik Awaludin, Galih Noor Alivian, Hesti Permata Sari, Tri Wisesa Soetisna, Dwi Novitasari
Aim: This study examined the association of preoperative anxiety and sex with new-onset arrhythmias after cardiac surgery and to highlight their implications for perioperative risk stratification and cardiac ICU handover. Background: New-onset arrhythmias are clinically important postoperative events after cardiac surgery and require timely recognition, continuous rhythm surveillance, and coordinated management during the transition from the operating room to the cardiac intensive care unit. Preoperative anxiety is a potentially modifiable patient-related factor, but its role in postoperative rhythm disturbance remains insufficiently integrated into perioperative risk assessment and handover communication. Methods: This prospective cohort study included 156 adult patients undergoing cardiac surgery and admitted postoperatively to a cardiac intensive care unit. Variables analyzed were age, sex, preoperative anxiety, and new-onset postoperative arrhythmias. Preoperative anxiety was assessed before surgery, and new-onset arrhythmias were identified during postoperative cardiac intensive care monitoring. Descriptive and bivariate analyses were performed. The study was reported in accordance with STROBE principles for observational cohort studies. Results: The mean age was 52.84 ± 13.25 years, with 78 men and 78 women. Preoperative anxiety was identified in 121 patients (77.60%), and new-onset postoperative arrhythmias occurred in 124 patients (79.50%). Preoperative anxiety was strongly associated with new-onset arrhythmias (crude OR = 30.82; 95% CI: 11.21–84.76; p < 0.001). Sex was also associated with new-onset arrhythmias (crude OR = 3.21; 95% CI: 1.37–7.49; p = 0.010), whereas age was not significant (p = 0.106). Conclusions: Preoperative anxiety and male sex were associated with new-onset arrhythmias after cardiac surgery. Integrating anxiety screening and sex-informed risk recognition into perioperative risk stratification, OR-to-Cardiac ICU handover, and postoperative rhythm surveillance may strengthen coordinated postoperative patient safety. © 2026 Elsevier Inc.
Master of Nursing, Universitas Jenderal Soedirman, Purwokerto, Indonesia; School of Nursing, Universitas Jenderal Soedirman, Purwokerto, Indonesia; Nutritional Department, Universitas Jenderal Soedirman, Purwokerto, Indonesia; National Cardiovascular Center Harapan Kita Hospital, Jakarta, Indonesia; Faculty of Health, Universitas Harapan Bangsa, Purwokerto, Indonesia; Galih Noor Alivian, School of Nursing, Universitas Jenderal Soedirman; Hesti Permata Sari, Nutritional Science Study Program, Universitas Jenderal Soedirman; Tri Wisesa Soetisna, National Cardiovascular Center Harapan Kita Hospital, Cardiothoracic Surgeon; Dwi Novitasari, Faculty of Health, Universitas Harapan Bangsa
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