Luo Wenqi, Huaibin Wang, Wenjun Zhen, Jie Tan, Xiaokang Ouyang, Zi Wang, Yujian Ma
Department of Cardiovascular Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China.
Heart Surg Forum. 2017 Feb 28;20(1):E038-E042. doi: 10.1532/hsf.1583.
Postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) is one of the most common complications that can contribute to an increased risk of mortality, particularly in older patients. The identification of predictors of POAF after CABG could impact patient care. This study aims to determine the risk factors of POAF in patients ≥60 years old who underwent isolated on-pump coronary artery bypass grafting (ONCAB) in order to provide a basis for the prevention and treatment of POAF after ONCAB.
Between October 2011 and November 2015, a total of 304 patients ≥60 years old underwent isolated ONCAB in our department. The patients were divided into 2 groups, the AF group and the non-AF group, according to the occurrence of POAF. A retrospective analysis was performed on the general characteristics and perioperative data of the patients. Logistic regression analysis was used to identify the predictors of POAF after ONCAB in patients ≥60 years old.
The incidence of POAF after ONCAB in patients ≥60 years old was 23.36% (71/304). Statistically significant differences were observed in patients' age, history of hypertension, left atrium diameter, European System for Cardiac Operative Risk Evaluation (EuroSCORE) I and II, and the highest level of serum creatinine after operation (all P < .05). Logistic regression analyses showed that a history of hypertension (OR = 2.575, CI 1.208-5.488, P = .014), left atrium diameter (OR = 1.105, CI 1.047-1.167, P = .000) and EuroSCORE I score (OR = 1.132, CI 1.001-1.279, P = .048) were independent risk factors for POAF after ONCAB in patients ≥60 years old.
The occurrence of POAF after isolated ONCAB in patients ≥60 years old was affected by many risk factors; a history of hypertension, the left atrium diameter and the EuroSCORE I score were all predictors of POAF.
冠状动脉旁路移植术(CABG)后发生的术后房颤(POAF)是最常见的并发症之一,可导致死亡风险增加,尤其是在老年患者中。识别CABG后POAF的预测因素可能会影响患者的治疗。本研究旨在确定年龄≥60岁的接受单纯体外循环冠状动脉旁路移植术(ONCAB)患者发生POAF的危险因素,以便为ONCAB后POAF的防治提供依据。
2011年10月至2015年11月期间,共有304例年龄≥60岁的患者在我科接受了单纯ONCAB。根据是否发生POAF将患者分为两组,即房颤组和非房颤组。对患者的一般特征和围手术期数据进行回顾性分析。采用Logistic回归分析确定年龄≥60岁的患者ONCAB后POAF的预测因素。
年龄≥60岁的患者ONCAB后POAF的发生率为23.36%(71/304)。在患者年龄、高血压病史、左心房直径、欧洲心脏手术风险评估系统(EuroSCORE)I和II以及术后血清肌酐最高水平方面观察到统计学上的显著差异(均P <.05)。Logistic回归分析显示,高血压病史(OR = 2.575,CI 1.208 - 5.488,P =.014)、左心房直径(OR = 1.105,CI 1.047 - 1.167,P =.0… )和EuroSCORE I评分(OR = 1.132,CI 1.001 - 1.279,P =.048)是年龄≥60岁的患者ONCAB后POAF的独立危险因素。
年龄≥60岁的患者单纯ONCAB后POAF的发生受多种危险因素影响;高血压病史、左心房直径和EuroSCORE I评分均为POAF的预测因素。 (注:英文原文中“P =.0… ”处疑似有误,翻译时保留原文状态)