Efird Jimmy T, Davies Stephen W, O'Neal Wesley T, Anderson Curtis A, Anderson Ethan J, O'Neal Jason B, Ferguson T Bruce, Chitwood W Randolph, Kypson Alan P
Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Eur J Cardiothorac Surg. 2014 Feb;45(2):e20-5. doi: 10.1093/ejcts/ezt529. Epub 2013 Nov 27.
Black patients are less likely to develop postoperative atrial fibrillation (POAF) following coronary artery bypass grafting (CABG) than whites. However, the influence of race and POAF on operative mortality has not been examined. The objective of this study was to determine the influence of race and POAF on operative mortality after CABG.
Patients undergoing elective CABG between 1992 and 2011 were included. Operative mortality was compared between patients with and those without new-onset POAF by race. Relative risk (RR) and 95% confidence intervals (CI) were computed using Poisson (robust variance estimates) and log-binomial regression models.
A total of 1215 (23%) patients developed POAF (white n=1060; black n=155) following CABG (N=5387). Operative mortality differed by POAF status within race category (white POAF: adjusted RR=1.4, 95% CI=0.86-2.2; black POAF: adjusted RR=5.0, 95% CI=1.9-13; Pinteraction=0.0016). Black POAF patients had a 2-fold increased risk of operative death compared with white POAF patients (Padjusted=0.052).
POAF was observed to be a stronger predictor of operative mortality in black compared with white patients undergoing elective CABG.
与白人相比，黑人患者冠状动脉旁路移植术（CABG）后发生术后房颤（POAF）的可能性较小。然而，种族和POAF对手术死亡率的影响尚未得到研究。本研究的目的是确定种族和POAF对CABG术后手术死亡率的影响。
纳入1992年至2011年间接受择期CABG的患者。按种族比较新发POAF患者和未发生POAF患者的手术死亡率。使用泊松（稳健方差估计）和对数二项回归模型计算相对风险（RR）和95%置信区间（CI）。
共有1215例（23%）患者在CABG后发生POAF（白人n = 1060；黑人n = 155）（N = 5387）。手术死亡率在种族类别内因POAF状态而异（白人POAF：调整后RR = 1.4，95%CI = 0.86 - 2.2；黑人POAF：调整后RR = 5.0，95%CI = 1.9 - 13；P交互作用 = 0.0016）。与白人POAF患者相比，黑人POAF患者手术死亡风险增加了2倍（调整后P = 0.052）。
在接受择期CABG的患者中，与白人相比，POAF被观察到是黑人手术死亡率更强的预测指标。
