Risk factors of postoperative atrial fibrillation in patients undergoing beating heart coronary artery bypass

N. Erdil, B. Akca
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Abstract

Aim: This study aims to establish new-onset atrial fibrillation (AF) risk factors and postoperative outcomes after off-pump coronary artery bypass graft (CABG) surgery. Material and Methods: Four hundred ninety patients who underwent off-pump CABG were enclosed in study. Patients divided into two groups in line with the development of new-onset AF as AF group (n=62) and non-AF group (n=428). Groups were compared in terms of preoperative clinical features and perioperative data, and multivariate analysis accomplished to identify independent clinical predictors of AF following off-pump CABG. Results: AF was presented in 62 (12.7%) of the patients, and those were significantly older and had significantly higher additive EuroSCORE scores than without AF. Also patients with postoperative AF had significantly prolonged intensive care unit and longer hospital stays at postoperative period. In the multivariant logistic regression analysis performed, advanced age, mean Euroscore, Mild to moderate mitral regurgitation, Prolonged air leak from thorax drain, mean ventilation time, severe pleural effusion, need for inotropic drug support were found to be risk factors for postoperative AF. Conclusion: Our study showed that age, high Euroscore, mild to moderate mitral regurgitation, prolonged ventilation time, severe pleural effusion and low cardiac output were risk factors of postoperative AF in patients underwent off-pump CABG. Also In patients who developed postoperative AF, prolonged intensive care unit and hospital stays were observed. Prospective randomized studies with larger patient series are recommended to support our study.
心脏搏动冠状动脉搭桥术患者术后房颤的危险因素
目的:本研究旨在确定非体外循环冠状动脉旁路移植术(CABG)术后新发心房颤动(AF)的危险因素和术后预后。材料和方法:490例接受非体外循环冠脉搭桥的患者被纳入研究。根据新发房颤的发展情况将患者分为AF组(n=62)和非AF组(n=428)。比较各组术前临床特征和围手术期数据,并进行多因素分析,以确定非体外循环冠状动脉搭桥后房颤的独立临床预测因素。结果:62例(12.7%)患者出现房颤,这些患者明显年龄较大,且EuroSCORE评分明显高于无房颤的患者。术后房颤患者的重症监护时间明显延长,术后住院时间明显延长。多变量logistic回归分析发现,高龄、平均Euroscore、轻度至中度二尖瓣返流、胸腔引流管漏气时间延长、平均通气时间、严重胸腔积液、需要肌力药物支持是发生af的危险因素。我们的研究表明,年龄、高Euroscore、轻中度二尖瓣反流、延长通气时间、严重胸腔积液和心输出量低是非体外循环冠状动脉搭桥患者术后房颤的危险因素。在发生术后房颤的患者中,观察到延长了重症监护病房和住院时间。推荐采用较大患者系列的前瞻性随机研究来支持我们的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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