Atrial fibrillation increases length of stay and cost after cardiac surgery in low risk patients targeted for early discharge

Chung, Mina K.; Asher, Craig R.; Dykstra, Dawn M.; Dimengo, Josephine M.; Weber, M.; Whitman, Gayle R.; McCarthy, Patrick M.; Nissen, Steven E.

doi:10.1016/s0735-1097(96)82135-8

Cited by 11 publications

(5 citation statements)

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“…Segundo informações publicadas até 1998, em torno de 468.000 operações de RM eram realizadas anualmente nos Estados Unidos (4,5) . A fibrilação atrial desenvolve-se em cerca de 18 a 33% dos pacientes que se submetem à RM, principalmente no período de 2 a 5 dias do procedimento, com pico de incidência do 2º ao 4º PO (4,6) .…”

Section: Comentáriosunclassified

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Fibrilação atrial e flutter após operação de revascularização do miocárdio: fatores de risco e resultados

Lima¹,

Sobral²,

Sobrinho³

et al. 2001

Rev Bras Cir Cardiovasc

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Fibrilação atrial e flutter (FAF) são as arritmias sustentadas mais comuns após revascularização do miocárdio (RM), tendo sido reconhecidas como a principal causa de morbidade após este tipo de operação (1) . Embora as conseqüências destas arritmias não sejam ameaçadoras para a vida, elas constituem um problema clínico muito importante, uma vez que a conversão para o ritmo sinusal é freqüentemente mandatória (2) . FAF após RM pode resultar em hipotensão e sintomas de insuficiência cardíaca, complicações embólicas (incidência aumentada de acidente vascular cerebral no pós-operatório), arritmias ventriculares e aumento do perío-do de internação hospitalar (3,4) . Os fatores respon- Casuística e Métodos: Foram analisados 275 pacientes submetidos à operação de revascularização do miocárdio isolada ou associada à correção de aneurisma de ventrículo esquerdo. A idade variou de 26 a 83 anos, com média de idade de 58,7 ± 9,5 anos. Cento e noventa e seis pacientes (71,3%) eram do sexo masculino.Resultados: A incidência total de fibrilação atrial e flutter pós-operatórios foi 16,4% com pico de incidência ocorrendo no segundo e terceiro dia de pós-operatório. Idade avançada, sexo masculino e história de fibrilação atrial ou flutter no pré-operatório foram identificados como fatores preditivos independentes de fibrilação atrial ou flutter no pós-operatório. Os pacientes que apresentaram FA ou flutter no pós-operatório em média 36 horas a mais na Unidade de Terapia Intensiva (UTI) e 4,8 dias a mais hospitalizados.Conclusão: A FA e flutter são arritmias comuns no pós-operatório de revascularização do miocárdio, tendo efeito significativo sobre os tempos de permanência na UTI e de internação hospitalar.

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Section: Comentáriosunclassified

“…FA após RM tem sido associada a um aumento significativo do período de internação hospitalar (1,3,4,(6)(7)(8) . É difícil, contudo, estabelecer se FA tem uma relação de causa com hospitalização prolongada ou se esta arritmia é apenas um marcador para pacientes mais complicados.…”

Section: Comentáriosunclassified

Fibrilação atrial e flutter após operação de revascularização do miocárdio: fatores de risco e resultados

Lima¹,

Sobral²,

Sobrinho³

et al. 2001

Rev Bras Cir Cardiovasc

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“…We observed that the occurrence of POAF is associated with a significantly increased length of hospital stay, according to the literature. The length of ICU stay was longer in the POAF group 16 days on average ( P <0.001 ), 8 days higher when comparing the patients in group I (twice as long), confirming its impact on morbidity and mortality [ 10 , 11 , 17 , 18 , 21 ] .…”

Section: Discussionmentioning

confidence: 79%

“…Another aspect worth noting is that the incidence of ARF that is also higher in the group with POAF: 12%, versus only 4% in group I, or that is, an incidence three times higher. A study assessing risk factors for the occurrence of stroke, transient ischemic attack and ARF in the postoperative period of CABG surgery found that atrial fibrillation and low cardiac output were significantly related to those complications [ 10 , 11 , 18 , 19 ] .…”

Section: Discussionmentioning

confidence: 99%

“…The length of stay of patients who develop POAF increases, on average, two to four days compared to those who remained in sinus rhythm, and this disease is the leading cause of post-discharge cardiac [ 9 ] surgery hospital readmission. Cerebrovascular accident (CVA), acute renal failure (ARF), hypotension, acute pulmonary edema (APE), increased length of stay in the intensive care unit (ICU) and estimated $ 10,000 in additional costs are directly associated with complications POAF [ 7 , 10 ] . Its occurrence is also associated with increased twice cardiovascular morbidity and mortality (4.7% versus 2.1% in the short term) [ 6 - 11 ] .…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Stroke and Acute renal failure in patients of Postoperative Atrial Fibrillation after Myocardial Revascularization

Barbieri¹,

Sobral²,

Gerônimo³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Introduction Postoperative atrial fibrillation is the most common arrhythmia in cardiac surgery, its incidence range between 20% and 40%. Objective Quantify the occurrence of stroke and acute renal insufficiency after myocardial revascularization surgery in patients who had atrial fibrillation postoperatively. Methods Cohort longitudinal bidirectional study, performed at Portuguese Beneficent Hospital (SP), with medical chart survey of patients undergoing myocardial revascularization surgery between June 2009 to July 2010. From a total of 3010 patients were weaned 382 patients that presented atrial fibrillation preoperatively and/or associated surgeries. The study was conducted in accordance with national and international following resolutions: ICH Harmonized Tripartite Guidelines for Good Clinical Practice - 1996; CNS196/96 Resolution, and Declaration of Helsinki. Results The 2628 patients included in this study were divided into two groups: Group I, who didn't show postoperative atrial fibrillation, with 2302 (87.6%) patients; and group II, with 326 (12.4%) who developed postoperative atrial fibrillation. The incidence of stroke in patients was 1.1% without postoperative atrial fibrillation vs. 4% with postoperative atrial fibrillation (P<0.001). Postoperative acute renal failure was observed in 12% of patients with postoperative atrial fibrillation and 2.4% in the group without postoperative atrial fibrillation (P<0.001), that is a relation 5 times greater. Conclusion In this study there was a high incidence of stroke and acute renal failure in patients with postoperative atrial fibrillation, with rates higher than those reported in the literature.

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A randomized, double-blind comparison of intravenous diltiazem and digoxin for atrial fibrillation after coronary artery bypass surgery

Tisdale

Padhi

Goldberg

et al. 1998

American Heart Journal

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Atrial fibrillation increases length of stay and cost after cardiac surgery in low risk patients targeted for early discharge

Cited by 11 publications

References 0 publications

Fibrilação atrial e flutter após operação de revascularização do miocárdio: fatores de risco e resultados

Fibrilação atrial e flutter após operação de revascularização do miocárdio: fatores de risco e resultados

Incidence of Stroke and Acute renal failure in patients of Postoperative Atrial Fibrillation after Myocardial Revascularization

A randomized, double-blind comparison of intravenous diltiazem and digoxin for atrial fibrillation after coronary artery bypass surgery

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