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 |
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| creator | 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 |
| description | 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 ( |
| doi_str_mv | 10.1053/j.jvca.2010.03.009 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_814465976</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1053077010001035</els_id><sourcerecordid>814465976</sourcerecordid><originalsourceid>FETCH-LOGICAL-c520t-995028bcde5f7291dcdc7e9ac5a2e9a054ec1298ef2f36bf91d583789bd181253</originalsourceid><addsrcrecordid>eNp9kcFq3DAQhkVpadK0L9BD0a2XeDuSVmu7lMBmyaaBQKFJ6FHIo3GR47USyQ7s21dm0x56yGmE-P4f5hvGPgpYCNDqS7fontAuJOQPUAuA-hU7FlrJolpK-Tq_M1VAWcIRe5dSByCE1uVbdiRBlyAqOGa_1mP0tudb30Tf93b0YeDrdqTINzY6b5HfTPE3xf1XfjWgdzQgnfKfPt3zrcUxxHTK7eD4BYYh7Dzy8ylm6D1709o-0YfnecLuthe3m-_F9Y_Lq836ukAtYSzqWoOsGnSk21LWwqHDkmqL2so8QC8JhawramWrVk2bCV2psqobJyohtTphnw-9DzE8TpRGs_MJKW8yUJiSqcRyudJ1ucqkPJAYQ0qRWvMQ_c7GvRFgZlOmM7NPM_s0oEz2mUOfnuunZkfuX-SvwAx8OwCUl3zyFE1CPztyPhKOxgX_cv_Zf3Hs_eDR9ve0p9SFKQ5ZnxEmSQPmZu6ZDyogHxOUVn8AlkGacw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>814465976</pqid></control><display><type>article</type><title>Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 (<0.5%) and with a limited increase of average length of hospitalization (24 hours) in patients with POAF. Conclusions The overall incidence of POAF in the authors' center is close to 30%; 95.3% of patients were discharged in sinus rhythm. The increase in length and costs of hospitalization (on average, 1.0 day with a burden of about €1,800/patient) were significantly lower than in previous investigations.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2010.03.009</identifier><identifier>PMID: 20570180</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2010-12, Vol.24 (6), p.952-958</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c520t-995028bcde5f7291dcdc7e9ac5a2e9a054ec1298ef2f36bf91d583789bd181253</citedby><cites>FETCH-LOGICAL-c520t-995028bcde5f7291dcdc7e9ac5a2e9a054ec1298ef2f36bf91d583789bd181253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053077010001035$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20570180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rostagno, Carlo, MD, PhD</creatorcontrib><creatorcontrib>La Meir, Mark, MD</creatorcontrib><creatorcontrib>Gelsomino, Sandro, MD, PhD</creatorcontrib><creatorcontrib>Ghilli, Lorenzo, MD</creatorcontrib><creatorcontrib>Rossi, Alessandra, MD</creatorcontrib><creatorcontrib>Carone, Enrico, MD</creatorcontrib><creatorcontrib>Braconi, Lucio, MD</creatorcontrib><creatorcontrib>Rosso, Gabriele, MD</creatorcontrib><creatorcontrib>Puggelli, Francesco, MD</creatorcontrib><creatorcontrib>Mattesini, Alessio, MD</creatorcontrib><creatorcontrib>Stefàno, Pier Luigi, MD</creatorcontrib><creatorcontrib>Padeletti, Luigi, MD</creatorcontrib><creatorcontrib>Maessen, Jos, MD, PhD</creatorcontrib><creatorcontrib>Gensini, Gian Franco, MD</creatorcontrib><title>Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>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 (<0.5%) and with a limited increase of average length of hospitalization (24 hours) in patients with POAF. Conclusions The overall incidence of POAF in the authors' center is close to 30%; 95.3% of patients were discharged in sinus rhythm. The increase in length and costs of hospitalization (on average, 1.0 day with a burden of about €1,800/patient) were significantly lower than in previous investigations.</description><subject>Age Factors</subject><subject>Aged</subject><subject>amiodarone</subject><subject>Amiodarone - therapeutic use</subject><subject>Anesthesia & Perioperative Care</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - economics</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - therapy</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - economics</subject><subject>Causality</subject><subject>Cost of Illness</subject><subject>Costs and Cost Analysis</subject><subject>Critical Care</subject><subject>Echocardiography</subject><subject>Electric Stimulation Therapy</subject><subject>Electrocardiography</subject><subject>Endpoint Determination</subject><subject>Female</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>perioperative complications</subject><subject>Postoperative Complications - economics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - therapy</subject><subject>Risk Factors</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFq3DAQhkVpadK0L9BD0a2XeDuSVmu7lMBmyaaBQKFJ6FHIo3GR47USyQ7s21dm0x56yGmE-P4f5hvGPgpYCNDqS7fontAuJOQPUAuA-hU7FlrJolpK-Tq_M1VAWcIRe5dSByCE1uVbdiRBlyAqOGa_1mP0tudb30Tf93b0YeDrdqTINzY6b5HfTPE3xf1XfjWgdzQgnfKfPt3zrcUxxHTK7eD4BYYh7Dzy8ylm6D1709o-0YfnecLuthe3m-_F9Y_Lq836ukAtYSzqWoOsGnSk21LWwqHDkmqL2so8QC8JhawramWrVk2bCV2psqobJyohtTphnw-9DzE8TpRGs_MJKW8yUJiSqcRyudJ1ucqkPJAYQ0qRWvMQ_c7GvRFgZlOmM7NPM_s0oEz2mUOfnuunZkfuX-SvwAx8OwCUl3zyFE1CPztyPhKOxgX_cv_Zf3Hs_eDR9ve0p9SFKQ5ZnxEmSQPmZu6ZDyogHxOUVn8AlkGacw</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Rostagno, Carlo, MD, PhD</creator><creator>La Meir, Mark, MD</creator><creator>Gelsomino, Sandro, MD, PhD</creator><creator>Ghilli, Lorenzo, MD</creator><creator>Rossi, Alessandra, MD</creator><creator>Carone, Enrico, MD</creator><creator>Braconi, Lucio, MD</creator><creator>Rosso, Gabriele, MD</creator><creator>Puggelli, Francesco, MD</creator><creator>Mattesini, Alessio, MD</creator><creator>Stefàno, Pier Luigi, MD</creator><creator>Padeletti, Luigi, MD</creator><creator>Maessen, Jos, MD, PhD</creator><creator>Gensini, Gian Franco, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20101201</creationdate><title>Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c520t-995028bcde5f7291dcdc7e9ac5a2e9a054ec1298ef2f36bf91d583789bd181253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>amiodarone</topic><topic>Amiodarone - therapeutic use</topic><topic>Anesthesia & Perioperative Care</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - economics</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - therapy</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - economics</topic><topic>Causality</topic><topic>Cost of Illness</topic><topic>Costs and Cost Analysis</topic><topic>Critical Care</topic><topic>Echocardiography</topic><topic>Electric Stimulation Therapy</topic><topic>Electrocardiography</topic><topic>Endpoint Determination</topic><topic>Female</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>perioperative complications</topic><topic>Postoperative Complications - economics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - therapy</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rostagno, Carlo, MD, PhD</creatorcontrib><creatorcontrib>La Meir, Mark, MD</creatorcontrib><creatorcontrib>Gelsomino, Sandro, MD, PhD</creatorcontrib><creatorcontrib>Ghilli, Lorenzo, MD</creatorcontrib><creatorcontrib>Rossi, Alessandra, MD</creatorcontrib><creatorcontrib>Carone, Enrico, MD</creatorcontrib><creatorcontrib>Braconi, Lucio, MD</creatorcontrib><creatorcontrib>Rosso, Gabriele, MD</creatorcontrib><creatorcontrib>Puggelli, Francesco, MD</creatorcontrib><creatorcontrib>Mattesini, Alessio, MD</creatorcontrib><creatorcontrib>Stefàno, Pier Luigi, MD</creatorcontrib><creatorcontrib>Padeletti, Luigi, MD</creatorcontrib><creatorcontrib>Maessen, Jos, MD, PhD</creatorcontrib><creatorcontrib>Gensini, Gian Franco, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rostagno, Carlo, MD, PhD</au><au>La Meir, Mark, MD</au><au>Gelsomino, Sandro, MD, PhD</au><au>Ghilli, Lorenzo, MD</au><au>Rossi, Alessandra, MD</au><au>Carone, Enrico, MD</au><au>Braconi, Lucio, MD</au><au>Rosso, Gabriele, MD</au><au>Puggelli, Francesco, MD</au><au>Mattesini, Alessio, MD</au><au>Stefàno, Pier Luigi, MD</au><au>Padeletti, Luigi, MD</au><au>Maessen, Jos, MD, PhD</au><au>Gensini, Gian Franco, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>24</volume><issue>6</issue><spage>952</spage><epage>958</epage><pages>952-958</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>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 (<0.5%) and with a limited increase of average length of hospitalization (24 hours) in patients with POAF. Conclusions The overall incidence of POAF in the authors' center is close to 30%; 95.3% of patients were discharged in sinus rhythm. The increase in length and costs of hospitalization (on average, 1.0 day with a burden of about €1,800/patient) were significantly lower than in previous investigations.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>20570180</pmid><doi>10.1053/j.jvca.2010.03.009</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 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 |
| title | Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden |
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