The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades
Objective Postoperative atrial fibrillation is the most common complication after cardiac surgery. A variety of postoperative atrial fibrillation risk factors have been reported, but study results have been inconsistent or contradictory, particularly in patients with preexisting atrial fibrillation....
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2011-02, Vol.141 (2), p.559-570 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Shen, Jeanne, BS Lall, Shelly, MD Zheng, Victoria, MD Buckley, Patricia, RHIT Damiano, Ralph J., MD Schuessler, Richard B., PhD |
| description | Objective Postoperative atrial fibrillation is the most common complication after cardiac surgery. A variety of postoperative atrial fibrillation risk factors have been reported, but study results have been inconsistent or contradictory, particularly in patients with preexisting atrial fibrillation. The incidence of postoperative atrial fibrillation was evaluated in a group of 10,390 patients undergoing cardiac surgery among a comprehensive range of risk factors to identify reliable predictors of postoperative atrial fibrillation. Methods This 20-year retrospective study examined the relationship between postoperative atrial fibrillation and demographic factors, preoperative health conditions and medications, operative procedures, and postoperative complications. Multivariate logistic regression models were used to evaluate potential predictors of postoperative atrial fibrillation. Results Increasing age, mitral valve surgery (odds ratio = 1.91), left ventricular aneurysm repair (odds ratio = 1.57), aortic valve surgery (odds ratio = 1.52), race (Caucasian) (odds ratio = 1.51), use of cardioplegia (odds ratio = 1.36), use of an intraaortic balloon pump (odds ratio = 1.28), previous congestive heart failure (odds ratio = 1.28), and hypertension (odds ratio = 1.15) were significantly associated with postoperative atrial fibrillation. The non-linear relationship between age and postoperative atrial fibrillation revealed the acceleration of postoperative atrial fibrillation risk in patients aged 55 years or more. In patients undergoing coronary artery bypass grafting, increasing age and previous congestive heart failure were the only factors associated with a higher risk of postoperative atrial fibrillation. There was no trend in incidence of postoperative atrial fibrillation over time. No protective factors against postoperative atrial fibrillation were detected, including commonly prescribed categories of medications. Conclusions The persistence of the problem of postoperative atrial fibrillation and the modest predictability using common risk factors suggest that limited progress has been made in understanding its cause and treatment. |
| doi_str_mv | 10.1016/j.jtcvs.2010.03.011 |
| format | Article |
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A variety of postoperative atrial fibrillation risk factors have been reported, but study results have been inconsistent or contradictory, particularly in patients with preexisting atrial fibrillation. The incidence of postoperative atrial fibrillation was evaluated in a group of 10,390 patients undergoing cardiac surgery among a comprehensive range of risk factors to identify reliable predictors of postoperative atrial fibrillation. Methods This 20-year retrospective study examined the relationship between postoperative atrial fibrillation and demographic factors, preoperative health conditions and medications, operative procedures, and postoperative complications. Multivariate logistic regression models were used to evaluate potential predictors of postoperative atrial fibrillation. Results Increasing age, mitral valve surgery (odds ratio = 1.91), left ventricular aneurysm repair (odds ratio = 1.57), aortic valve surgery (odds ratio = 1.52), race (Caucasian) (odds ratio = 1.51), use of cardioplegia (odds ratio = 1.36), use of an intraaortic balloon pump (odds ratio = 1.28), previous congestive heart failure (odds ratio = 1.28), and hypertension (odds ratio = 1.15) were significantly associated with postoperative atrial fibrillation. The non-linear relationship between age and postoperative atrial fibrillation revealed the acceleration of postoperative atrial fibrillation risk in patients aged 55 years or more. In patients undergoing coronary artery bypass grafting, increasing age and previous congestive heart failure were the only factors associated with a higher risk of postoperative atrial fibrillation. There was no trend in incidence of postoperative atrial fibrillation over time. No protective factors against postoperative atrial fibrillation were detected, including commonly prescribed categories of medications. Conclusions The persistence of the problem of postoperative atrial fibrillation and the modest predictability using common risk factors suggest that limited progress has been made in understanding its cause and treatment.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2010.03.011</identifier><identifier>PMID: 20434173</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Atrial Fibrillation - prevention & control ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiac Surgical Procedures - adverse effects ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Chi-Square Distribution ; Child ; Female ; Heart ; Humans ; Incidence ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Missouri ; Odds Ratio ; Pneumology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2011-02, Vol.141 (2), p.559-570</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2011 The American Association for Thoracic Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c609t-2c8d324558d8cfc1b023b97af598b8c88a82b5e7d1e12ffb4b29158395c5ddbc3</citedby><cites>FETCH-LOGICAL-c609t-2c8d324558d8cfc1b023b97af598b8c88a82b5e7d1e12ffb4b29158395c5ddbc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2010.03.011$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23842857$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20434173$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shen, Jeanne, BS</creatorcontrib><creatorcontrib>Lall, Shelly, MD</creatorcontrib><creatorcontrib>Zheng, Victoria, MD</creatorcontrib><creatorcontrib>Buckley, Patricia, RHIT</creatorcontrib><creatorcontrib>Damiano, Ralph J., MD</creatorcontrib><creatorcontrib>Schuessler, Richard B., PhD</creatorcontrib><title>The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective Postoperative atrial fibrillation is the most common complication after cardiac surgery. A variety of postoperative atrial fibrillation risk factors have been reported, but study results have been inconsistent or contradictory, particularly in patients with preexisting atrial fibrillation. The incidence of postoperative atrial fibrillation was evaluated in a group of 10,390 patients undergoing cardiac surgery among a comprehensive range of risk factors to identify reliable predictors of postoperative atrial fibrillation. Methods This 20-year retrospective study examined the relationship between postoperative atrial fibrillation and demographic factors, preoperative health conditions and medications, operative procedures, and postoperative complications. Multivariate logistic regression models were used to evaluate potential predictors of postoperative atrial fibrillation. Results Increasing age, mitral valve surgery (odds ratio = 1.91), left ventricular aneurysm repair (odds ratio = 1.57), aortic valve surgery (odds ratio = 1.52), race (Caucasian) (odds ratio = 1.51), use of cardioplegia (odds ratio = 1.36), use of an intraaortic balloon pump (odds ratio = 1.28), previous congestive heart failure (odds ratio = 1.28), and hypertension (odds ratio = 1.15) were significantly associated with postoperative atrial fibrillation. The non-linear relationship between age and postoperative atrial fibrillation revealed the acceleration of postoperative atrial fibrillation risk in patients aged 55 years or more. In patients undergoing coronary artery bypass grafting, increasing age and previous congestive heart failure were the only factors associated with a higher risk of postoperative atrial fibrillation. There was no trend in incidence of postoperative atrial fibrillation over time. No protective factors against postoperative atrial fibrillation were detected, including commonly prescribed categories of medications. Conclusions The persistence of the problem of postoperative atrial fibrillation and the modest predictability using common risk factors suggest that limited progress has been made in understanding its cause and treatment.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Fibrillation - prevention & control</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Chi-Square Distribution</subject><subject>Child</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Incidence</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Missouri</subject><subject>Odds Ratio</subject><subject>Pneumology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUstu1DAUjRCITgtfgIS8QV1l8CNOHCQqVRUvqRILisTOcpyb1kPGHnydGfr3dTpDeWxYWTo-59zHuUXxgtElo6x-vVqukt3iktOMULGkjD0qFoy2TVkr-e1xsaCU81JyLo6KY8QVpbShrH1aHHFaiYo1YlHsrm6AbCCiwwQ-kU0M3QhrEgbiYVcGj5DBgClkkkluC8Sk6MxIBtdFN44ZC_4NOSfo_PUIpfOYXJpmlMDPLHLgLZCwhUjSLpAerOkBnxVPBjMiPD-8J8XX9--uLj6Wl58_fLo4vyxtTdtUcqt6wSspVa_sYFlHuejaxgyyVZ2yShnFOwlNz4DxYeiqjrdMKtFKK_u-s-KkONv7bqZuDb3NM0Yz6k10axNvdTBO__3j3Y2-DludfRopeDY4PRjE8GMCTHrt0EIe3EOYUKtKipbTts5MsWfaGBAjDA9VGNVzYnql7xPTc2KaCp0Ty6qXfzb4oPkVUSa8OhAMWjMO0Xjr8DdPqIor2WTe2z0P8jq3DqJGe7_73kWwSffB_aeRs3_0dnTe5ZLf4RZwFaboc1KaaeSa6i_zcc23xfJZCVpLcQdRYs6r</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Shen, Jeanne, BS</creator><creator>Lall, Shelly, MD</creator><creator>Zheng, Victoria, MD</creator><creator>Buckley, Patricia, RHIT</creator><creator>Damiano, Ralph J., MD</creator><creator>Schuessler, Richard B., PhD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><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><scope>5PM</scope></search><sort><creationdate>20110201</creationdate><title>The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades</title><author>Shen, Jeanne, BS ; Lall, Shelly, MD ; Zheng, Victoria, MD ; Buckley, Patricia, RHIT ; Damiano, Ralph J., MD ; Schuessler, Richard B., PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c609t-2c8d324558d8cfc1b023b97af598b8c88a82b5e7d1e12ffb4b29158395c5ddbc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - etiology</topic><topic>Atrial Fibrillation - prevention & control</topic><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Chi-Square Distribution</topic><topic>Child</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Incidence</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Missouri</topic><topic>Odds Ratio</topic><topic>Pneumology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shen, Jeanne, BS</creatorcontrib><creatorcontrib>Lall, Shelly, MD</creatorcontrib><creatorcontrib>Zheng, Victoria, MD</creatorcontrib><creatorcontrib>Buckley, Patricia, RHIT</creatorcontrib><creatorcontrib>Damiano, Ralph J., MD</creatorcontrib><creatorcontrib>Schuessler, Richard B., PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shen, Jeanne, BS</au><au>Lall, Shelly, MD</au><au>Zheng, Victoria, MD</au><au>Buckley, Patricia, RHIT</au><au>Damiano, Ralph J., MD</au><au>Schuessler, Richard B., PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>141</volume><issue>2</issue><spage>559</spage><epage>570</epage><pages>559-570</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objective Postoperative atrial fibrillation is the most common complication after cardiac surgery. A variety of postoperative atrial fibrillation risk factors have been reported, but study results have been inconsistent or contradictory, particularly in patients with preexisting atrial fibrillation. The incidence of postoperative atrial fibrillation was evaluated in a group of 10,390 patients undergoing cardiac surgery among a comprehensive range of risk factors to identify reliable predictors of postoperative atrial fibrillation. Methods This 20-year retrospective study examined the relationship between postoperative atrial fibrillation and demographic factors, preoperative health conditions and medications, operative procedures, and postoperative complications. Multivariate logistic regression models were used to evaluate potential predictors of postoperative atrial fibrillation. Results Increasing age, mitral valve surgery (odds ratio = 1.91), left ventricular aneurysm repair (odds ratio = 1.57), aortic valve surgery (odds ratio = 1.52), race (Caucasian) (odds ratio = 1.51), use of cardioplegia (odds ratio = 1.36), use of an intraaortic balloon pump (odds ratio = 1.28), previous congestive heart failure (odds ratio = 1.28), and hypertension (odds ratio = 1.15) were significantly associated with postoperative atrial fibrillation. The non-linear relationship between age and postoperative atrial fibrillation revealed the acceleration of postoperative atrial fibrillation risk in patients aged 55 years or more. In patients undergoing coronary artery bypass grafting, increasing age and previous congestive heart failure were the only factors associated with a higher risk of postoperative atrial fibrillation. There was no trend in incidence of postoperative atrial fibrillation over time. No protective factors against postoperative atrial fibrillation were detected, including commonly prescribed categories of medications. Conclusions The persistence of the problem of postoperative atrial fibrillation and the modest predictability using common risk factors suggest that limited progress has been made in understanding its cause and treatment.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>20434173</pmid><doi>10.1016/j.jtcvs.2010.03.011</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Atrial Fibrillation - prevention & control Biological and medical sciences Cardiac dysrhythmias Cardiac Surgical Procedures - adverse effects Cardiology. Vascular system Cardiothoracic Surgery Chi-Square Distribution Child Female Heart Humans Incidence Logistic Models Male Medical sciences Middle Aged Missouri Odds Ratio Pneumology Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome Young Adult |
| title | The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades |
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