Predictors of Postoperative Atrial Fibrillation after On-Pump Coronary Artery Bypass Grafting: Is Duration of Mechanical Ventilation Time a Risk Factor?
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- Erdil Nevzat
- Department of Cardiovascular Surgery, Inonu University, School of Medicine, Malatya, Turkey
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- Gedik Ender
- Department of Anaesthesiology and Reanimation, Inonu Uni versity, School of Medicine, Malatya, Turkey
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- Donmez Koksal
- Department of Cardiovascular Surgery, Inonu University, School of Medicine, Malatya, Turkey
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- Erdil Feray
- Department of Anaesthesiology and Reanimation, Inonu Uni versity, School of Medicine, Malatya, Turkey
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- Aldemir Mustafa
- Department of Cardiovascular Surgery, Anadolu Hospital, Antalya, Turkey
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- Battaloglu Bektas
- Department of Cardiovascular Surgery, Inonu University, School of Medicine, Malatya, Turkey
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- Yologlu Saim
- Department of Biostatistics, Inonu University, School of Medi cine, Malatya, Turkey
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Purpose: This study aimed to establish the role of risk factors in the etiology of postoperative atrial fibrillation (AF) after coronary artery bypass grafting (CABG).Methods: Between September 2001 and March 2008, 1040 patients underwent isolated CABG at our clinic. Nine hundred and eleven of these patients did not have any AF(Non-AF Group) and the other one hundred and twenty-nine had AF (AF Group). A retrospective study was performed for patient, disease and treatment related factors and multivariate analysis was used to identify independent clinical predictors of postoperative AF.Results: Postoperative AF was identified in 129 (12.4%) of the patients, and those were significantly older and had significantly higher additive EuroSCORE score as compared with patients without AF. During the postoperative course, patients with postoperative AF also had significantly higher and prolonged (≥6 hours) mechanical ventilation time, longer and prolonged intensive care unit stay and longer hospital stay. Logistic regression analysis revealed that postoperative AF development ratio was 1.690 times higher when the ventilation time was over 6 hours (OR 1.690, 95% CI 1.092-2.615, p = 0.018); 1.240times higher in the presence of elevated additive EuroSCORE score (OR 1.240, 95% CI1.109-1.385, p = 0.0001); 1.052 times higher in the presence of advanced age (OR 1.052,95% CI 1.031-1.0741, p = 0.0001).Conclusion: Analysis of our data reveals that, patient's age, additive EuroSCORE score, and prolonged ventilation are predictors of postoperative AF. Identification of risk factors might lead to better prevention of this problem and its potential consequences. However, to support our investigation and obtain more reliable evidence, prospective randomized controlled trials are needed.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 20 (2), 135-142, 2014
Annals of Thoracic and Cardiovascular Surgery 編集委員会