Author(s): Kalavrouziotis D, Buth KJ, Ali IS
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Abstract BACKGROUND: The impact of new-onset postoperative atrial fibrillation (NAF) on in-hospital mortality (IHM) following cardiac surgery is unknown. METHODS: All patients without preoperative atrial fibrillation undergoing isolated coronary artery bypass graft surgery (CABG) and concomitant CABG and valve surgery were identified (n = 7,347). The association between NAF and IHM was determined using logistic regression modeling. Also, propensity score analysis was used to create two matched subgroups of patients with and without NAF (n = 2,015 in each group). The secondary outcomes examined were stroke, myocardial infarction (MI), intra-aortic balloon pump use, GI complications, deep sternal wound infection (DSWI), septicemia, renal failure, and length of stay. RESULTS: NAF developed in 2,047 patients (27.9\%). NAF was not an independent predictor of IHM (odds ratio, 0.8; 95\% confidence interval, 0.6 to 1.2; p = 0.3). In multivariate analysis, NAF was associated with age >/= 60 years, combined procedures, preoperative MI within 7 days of surgery, COPD, cerebrovascular disease, and male gender. Propensity-adjusted results revealed no difference in IHM between NAF vs no-NAF patients (2.9\% vs 3.5\%, respectively; Bonferroni-corrected p = 0.99). However, GI complications (4.2\% vs 2.1\%), DSWI (1.3\% vs 0.4\%), septicemia (4.0\% vs 1.1\%), renal failure (7.6\% vs 4.3\%), and length of stay (8 days vs 6 days) were significantly increased in patients with NAF. CONCLUSION: NAF following cardiac surgery is not associated with increased IHM.
This article was published in Chest
and referenced in Journal of Clinical & Experimental Cardiology