Clinical Risk Factors for Postoperative Atrial Fibrillation among Patients after Cardiac Surgery

Yamashita, Kennosuke; Hu, Nan; Ranjan, Ravi; Selzman, Craig H.; Dosdall, Derek J.

doi:10.1055/s-0038-1667065

Cited by 48 publications

(60 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LV diastolic dysfunction is markedly more severe in patients with HOCM compared with the general population (7). Hypertension is the most significant risk factor associated with the development of LV diastolic dysfunction (26), and by aggravating LV diastolic dysfunction, it may be involved in the development of POAF. The preoperative LVEF did not differ between the groups of patients with HOCM in this study, because LV diastolic dysfunction is a key characteristic of these patients (15).…”

Section: Discussionmentioning

confidence: 99%

The preoperative glomerular filtration rate predicts new-onset postoperative atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy who undergo isolated septal myectomy

et al. 2021

View full text Add to dashboard Cite

Background: Few studies have focused on new-onset postoperative atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy who have undergone septal myectomy. Therefore, we investigated the incidence and prognosis effects of postoperative atrial fibrillation following septal myectomy in patients with hypertensive obstructive cardiomyopathy. Additionally, we investigated the relationship of estimated glomerular filtration rate and postoperative atrial fibrillation.Methods: Data from 300 patients with hypertrophic obstructive cardiomyopathy who underwent isolated surgical septal myectomy were collected from January 2012 to March 2018. Results: The overall incidence of postoperative atrial fibrillation during hospitalization was 22.67% (68 of 300 patients). Patients with postoperative atrial fibrillation were older (P<0.001), had lower preoperative estimated glomerular filtration rate (P<0.001), and a larger preoperative left atrial diameter (P=0.038) compared to patients without. The preoperative estimated glomerular filtration rate predicted postoperative atrial fibrillation with sensitivity and specificity of 0.824 and 0.578 (P<0.001), respectively. Multivariate regression analyses showed that age [odds ratio (OR) =1.090, 95% confidence interval (CI): 1.034-1.110], an New York Heart Association functional class ≥ III (OR =2.985, 95% CI: 1.349-6.604), hypertension (OR =2.212, 95% CI: 1.062-4.608), a history of syncope (OR =3.890, 95% CI: 1.741-8.692), and the preoperative estimated glomerular filtration rate (OR =0.981, 95% CI: 0.965-0.996) were independent risk factors associated in the development of postoperative atrial fibrillation. Survival analysis showed that the incidence of long-term cardiovascular events was higher in the patients with postoperative atrial fibrillation than that in the patients without the condition (P<0.001). Conclusions:The preoperative estimated glomerular filtration rate was a moderate predictor of postoperative atrial fibrillation after septal myectomy. Postoperative atrial fibrillation affected the early recovery and the long-term prognoses of patients with hypertrophic obstructive cardiomyopathy who underwent septal myectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

The preoperative glomerular filtration rate predicts new-onset postoperative atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy who undergo isolated septal myectomy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…POAF is the most frequent complication following cardiac surgery and has major impacts on patient outcomes and healthcare costs. Accurately measuring POAF incidence is important for better understanding its risk factors and for determining the effectiveness of preventive interventions, which are still suboptimal [6]. However, few well-validated and efficient measures of POAF incidence are currently available [7].…”

Section: Discussionmentioning

confidence: 99%

“…Ultimately, longer ICU and hospital stays further increase the cost of a hospitalization [1]. Given these figures, there is a pressing need to better understand the risk factors associated with POAF incidence and to assess the effectiveness of preventive interventions [6]. However, an important prerequisite for meeting these requirements is to have access to an accurate and efficient measure of POAF incidence.…”

Section: Introductionmentioning

confidence: 99%

Validation of an algorithm based on administrative data to detect new onset of atrial fibrillation after cardiac surgery

Labelle

Farand

Vincelette

et al. 2020

BMC Med Res Methodol

View full text Add to dashboard Cite

Introduction: Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery associated with important morbidity, mortality, and costs. To assess the effectiveness of preventive interventions, an important prerequisite is to have access to accurate measures of POAF incidence. The aim of this study was to develop and validate such a measure. Methods: A validation study was conducted at two large Canadian university health centers. First, a random sample of 976 (10.4%) patients who had cardiac surgery at these sites between 2010 and 2016 was generated. Then, a reference standard assessment of their medical records was performed to determine their true POAF status on discharge (positive/negative). The accuracy of various algorithms combining diagnostic and procedure codes from: 1) the current hospitalization, and 2) hospitalizations up to 6 years before the current hospitalization was assessed in comparison with the reference standard. Overall and site-specific estimates of sensitivity, specificity, positive (PPV), and negative (NPV) predictive values were generated, along with their 95%CIs. Results: Upon manual review, 324 (33.2%) patients were POAF-positive. Our best-performing algorithm combining data from both sites used a look-back window of 6 years to exclude patients previously known for AF. This algorithm achieved 70.4% sensitivity (95%CI: 65.1-75.3), 86.0% specificity (95%CI: 83.1-88.6), 71.5% PPV (95%CI: 66.2-76.4), and 85.4% NPV (95%CI: 82.5-88.0). However, significant site-specific differences in sensitivity and NPV were observed. Conclusion: An algorithm based on administrative data can identify POAF patients with moderate accuracy. However, site-specific variations in coding practices have significant impact on accuracy.

show abstract

“…It has been associated with adverse outcomes including a significant increase in hospitalization stay, readmissions, and mortality. 1 Obesity is a growing global health problem with negative impact on the cardiovascular system and an increased incidence of atrial fibrillation (AF). The etiology of atrial fibrillation ''vulnerability'' in obese subjects is still not completely elucidated, but probably multifactorial.…”

Section: Hussam Ali MD Fesc Fehra Faiac and Riccardo Cappato Mdmentioning

confidence: 99%

Commentary: Obesity and cardiac surgery—Double trouble for the surgeon and arrhythmologist

Ali

Cappato

2020

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

Clinical Risk Factors for Postoperative Atrial Fibrillation among Patients after Cardiac Surgery

Abstract: The present analysis suggested that older age and history of heart failure were significant risk factors for POAF consistently whether the included studies were prospective or retrospective datasets.

Cited by 48 publications

References 59 publications

The preoperative glomerular filtration rate predicts new-onset postoperative atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy who undergo isolated septal myectomy

The preoperative glomerular filtration rate predicts new-onset postoperative atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy who undergo isolated septal myectomy

Validation of an algorithm based on administrative data to detect new onset of atrial fibrillation after cardiac surgery

Commentary: Obesity and cardiac surgery—Double trouble for the surgeon and arrhythmologist

Contact Info

Product

Resources

About