학술논문
Effects of postoperative atrial fibrillation on cardiac surgery outcomes in Vietnam: a prospective multicenter study.
Document Type
Academic Journal
Author
Hung LT; Department of Interventional Cardiology, Heart Institude of Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Online Research Club, Nagasaki, Japan.; Minh Duc NT; Online Research Club, Nagasaki, Japan.; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Nam NH; Online Research Club, Nagasaki, Japan.; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.; Shah J; Weill Cornell Medicine, New York, NY, USA.; Tuan Anh PT; Cardiovascular Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam.; Do Quang Huan; Department of Interventional Cardiology, Heart Institude of Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Do Van Trang; Ben Cat Hospital, Binh Duong Province, Vietnam.; Loc LQ; Online Research Club, Nagasaki, Japan.; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Zia S; Online Research Club, Nagasaki, Japan.; American University of the Caribbean Medical School, Cupe Coy, Saint Maarten.; Van Sy H; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Internal Cardiology Department of Cho Ray Hospital, Vietnam.; Huy NT; Online Research Club, Nagasaki, Japan.; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Source
Publisher: Taylor & Francis Country of Publication: England NLM ID: 101268948 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2154-8331 (Print) Linking ISSN: 21548331 NLM ISO Abbreviation: Hosp Pract (1995) Subsets: MEDLINE
Subject
Language
English
ISSN
2154-8331
Abstract
Background: This study was designed to assess the impact of postoperative atrial fibrillation (POAF) on short- and long-term outcomes after cardiac surgery.
Methods: We prospectively assessed POAF concerning outcomes in 379 adult patients who had undergone cardiac surgery in two heart surgery centers with a follow-up period of one year for every patient. The effects of POAF on postoperative events were evaluated using Logistic regression, Cox regression (adjusted for propensity score), and Kaplan-Meier analysis.
Results: The incidence of POAF was 27.2%. Multivariable logistic regression analysis revealed POAF was associated with an increased risk of 6-month (OR = 5.36; CI: 1.51-18.94; p = 0.009), and 1-year mortality (OR = 4.56; CI: 1.29-16.04; p = 0.018) as well as Major Adverse Cardiocerebral Events (MACEs; acute MI, cardiac arrest, low cardiac output after surgery, third-degree atrioventricular block or stroke; OR = 3.02; CI: 1.29-7.05; p = 0.011), Intensive Care Unit (ICU) stay > 3 days (OR = 2.39; CI: 1.14-5.00; p = 0.021), and postoperative stay > 14 days (OR = 3.12; CI: 1.65-5.90; p < 0.001). Multivariable Cox regression analysis showed POAF as an independent predictor of mortality at one year (HR = 2.86; CI: 1.05-7.75; p = 0.038). Discharge plans including statin and beta-blocker had an independent association with a reduced mortality at one year (HR = 0.22; CI: 0.05-0.96; p = 0.045; HR = 0.16; CI: 0.03-0.87; p = 0.034, respectively).
Conclusions: POAF is associated with an increased risk of morbidity, all-cause mortality, and hospital duration. Statins and beta-blockers that were included in discharge plans had an independent association with reduction in 1-year all-cause mortality.
Methods: We prospectively assessed POAF concerning outcomes in 379 adult patients who had undergone cardiac surgery in two heart surgery centers with a follow-up period of one year for every patient. The effects of POAF on postoperative events were evaluated using Logistic regression, Cox regression (adjusted for propensity score), and Kaplan-Meier analysis.
Results: The incidence of POAF was 27.2%. Multivariable logistic regression analysis revealed POAF was associated with an increased risk of 6-month (OR = 5.36; CI: 1.51-18.94; p = 0.009), and 1-year mortality (OR = 4.56; CI: 1.29-16.04; p = 0.018) as well as Major Adverse Cardiocerebral Events (MACEs; acute MI, cardiac arrest, low cardiac output after surgery, third-degree atrioventricular block or stroke; OR = 3.02; CI: 1.29-7.05; p = 0.011), Intensive Care Unit (ICU) stay > 3 days (OR = 2.39; CI: 1.14-5.00; p = 0.021), and postoperative stay > 14 days (OR = 3.12; CI: 1.65-5.90; p < 0.001). Multivariable Cox regression analysis showed POAF as an independent predictor of mortality at one year (HR = 2.86; CI: 1.05-7.75; p = 0.038). Discharge plans including statin and beta-blocker had an independent association with a reduced mortality at one year (HR = 0.22; CI: 0.05-0.96; p = 0.045; HR = 0.16; CI: 0.03-0.87; p = 0.034, respectively).
Conclusions: POAF is associated with an increased risk of morbidity, all-cause mortality, and hospital duration. Statins and beta-blockers that were included in discharge plans had an independent association with reduction in 1-year all-cause mortality.