Miwa Arakawa1, Hiroaki Miyata2, Naomichi Uchida3, Noboru Motomura2, Akira Katayama4, Kentaro Tamura5, Taijiro Sueda6, Shinichi Takamoto7. 1. Department of Cardiovascular Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan. Electronic address: sutohmiwa@gmail.com. 2. Department of Healthcare Quality Assessment Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 3. Department of Cardiovascular Surgery, Tsuchiya General Hospital, Hirosima, Japan. 4. Department of Cardiovascular Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan. 5. Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Okayama, Japan. 6. Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. 7. Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) increases considerably the chances of morbidity and mortality after cardiac surgery. The objective of this study was to identify the major risk factors responsible for POAF after thoracic aortic surgery in order to define preventive measures. METHODS: We analyzed 12,260 records (between January 1, 2004, and December 31, 2008) obtained from the Japan Adult Cardiovascular Surgery Database. Patients with history of AF were excluded. Data were collected for 12 preoperative and 10 operative risk factors that had been proven or believed to influence POAF. The relationship between the risk factors and outcome was assessed by the Fisher exact test, Student t test, and multiple logistic regression analysis. RESULTS: The patients' mean age (± standard deviation) was 67.5 ± 12.7 years, and 27% of the subjects were women. The incidence of POAF was 17.1%. The following risk factors were associated with increased POAF: age (p < 0.0001), history of smoking (p < = 0.020), hypertension (p = 0.020), congestive heart failure (p < 0.0001), urgent operation (p = 0.023), and concomitant with nonelective coronary artery bypass (p = 0.022). Postoperative mortality and postoperative stroke were significantly increased in patients with POAF (p < 0.0001 in both cases). The odds ratios for the POAF risk factors were as follows: replacement of the ascending aorta, 1.67; aortic arch, 1.62; aortic root, 1.42; concomitant with valve operation, 1.35; age, 1.27; and urgent operation, 1.22. CONCLUSIONS: Several risk factors contribute to the incidence of POAF after thoracic aortic surgery. We found that POAF significantly increased 30-day operative mortality (p < 0.0001). Our findings can be used to develop a risk stratification system for the prediction of POAF.
BACKGROUND:Postoperative atrial fibrillation (POAF) increases considerably the chances of morbidity and mortality after cardiac surgery. The objective of this study was to identify the major risk factors responsible for POAF after thoracic aortic surgery in order to define preventive measures. METHODS: We analyzed 12,260 records (between January 1, 2004, and December 31, 2008) obtained from the Japan Adult Cardiovascular Surgery Database. Patients with history of AF were excluded. Data were collected for 12 preoperative and 10 operative risk factors that had been proven or believed to influence POAF. The relationship between the risk factors and outcome was assessed by the Fisher exact test, Student t test, and multiple logistic regression analysis. RESULTS: The patients' mean age (± standard deviation) was 67.5 ± 12.7 years, and 27% of the subjects were women. The incidence of POAF was 17.1%. The following risk factors were associated with increased POAF: age (p < 0.0001), history of smoking (p < = 0.020), hypertension (p = 0.020), congestive heart failure (p < 0.0001), urgent operation (p = 0.023), and concomitant with nonelective coronary artery bypass (p = 0.022). Postoperative mortality and postoperative stroke were significantly increased in patients with POAF (p < 0.0001 in both cases). The odds ratios for the POAF risk factors were as follows: replacement of the ascending aorta, 1.67; aortic arch, 1.62; aortic root, 1.42; concomitant with valve operation, 1.35; age, 1.27; and urgent operation, 1.22. CONCLUSIONS: Several risk factors contribute to the incidence of POAF after thoracic aortic surgery. We found that POAF significantly increased 30-day operative mortality (p < 0.0001). Our findings can be used to develop a risk stratification system for the prediction of POAF.
Authors: Pier Luigi Stefàno; Marco Bugetti; Guido Del Monaco; Gloria Popescu; Paolo Pieragnoli; Giuseppe Ricciardi; Laura Perrotta; Luca Checchi; Roberto Rondine; Sergio Bevilacqua; Carlo Fumagalli; Niccolò Marchionni; Antonio Michelucci Journal: J Cardiothorac Surg Date: 2020-10-15 Impact factor: 1.637
Authors: Katelyn Monaghan; Felix Orelaru; Aroma Naeem; Rana-Armaghan Ahmad; Xiaoting Wu; Karen M Kim; Shinichi Fukuhara; Himanshu J Patel; G Michael Deeb; Bo Yang Journal: Cardiol Cardiovasc Med Date: 2021-12-03