Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden

Objective To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization. Design A prospective observational study. Methods Patients who underwent cardiac surgery from...

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Veröffentlicht in:	Journal of cardiothoracic and vascular anesthesia 2010-12, Vol.24 (6), p.952-958
Hauptverfasser:	Rostagno, Carlo, MD, PhD, La Meir, Mark, MD, Gelsomino, Sandro, MD, PhD, Ghilli, Lorenzo, MD, Rossi, Alessandra, MD, Carone, Enrico, MD, Braconi, Lucio, MD, Rosso, Gabriele, MD, Puggelli, Francesco, MD, Mattesini, Alessio, MD, Stefàno, Pier Luigi, MD, Padeletti, Luigi, MD, Maessen, Jos, MD, PhD, Gensini, Gian Franco, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Age Factors Aged amiodarone Amiodarone - therapeutic use Anesthesia & Perioperative Care Anti-Arrhythmia Agents - therapeutic use atrial fibrillation Atrial Fibrillation - economics Atrial Fibrillation - epidemiology Atrial Fibrillation - therapy cardiac surgery Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - economics Causality Cost of Illness Costs and Cost Analysis Critical Care Echocardiography Electric Stimulation Therapy Electrocardiography Endpoint Determination Female Hospitalization - economics Humans Length of Stay Logistic Models Middle Aged Multivariate Analysis Odds Ratio perioperative complications Postoperative Complications - economics Postoperative Complications - epidemiology Postoperative Complications - therapy Risk Factors
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Zusammenfassung:	Objective To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization. Design A prospective observational study. Methods Patients who underwent cardiac surgery from January 1, 2007 to December 31, 2007. Interventions Electrocardiography was continuously monitored after surgery. Patients with symptomatic new-onset atrial fibrillation or lasting >15 minutes were treated with amiodarone and with DC shock in prolonged cases. Results POAF occurred in 29.7%, with the higher incidence between the 1st and 4th postoperative day. Age ( p < 0.001), atrial size >40 mm ( p < 0.001), previous episodes of AF ( p < 0.001), female sex ( p = 0.010), and combined valve and bypass surgery ( p = 0.012) were multivariate predictors of POAF at logistic regression. Sinus rhythm was restored by early treatment in 205 of 215 patients. This was associated with a low incidence of cerebrovascular events (
ISSN:	1053-0770 1532-8422
DOI:	10.1053/j.jvca.2010.03.009