Erdolu Burak, As Ahmet Kagan, Engin Mesut
Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Yıldırım/Bursa, Turkey.
Department of Cardiovascular Surgery, University of Health Sciences, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey.
Heart Surg Forum. 2020 Feb 27;23(1):E088-E092. doi: 10.1532/hsf.2771.
Backround: Postoperative atrial fibrillation (PoAF), the most common arrythmia observed in 18-40% of patients following coronary artery bypass surgery, may cause hemodynamic disturbances and increase embolism risk. The aim of this study was to investigate the relationship of HATCH score with PoAF in patients who underwent off-pump coronary artery bypass grafting (OPCABG) and evaluate the effect of preoperatively calculated neutrophil-to-lymphocyte ratio (NLR) on PoAF.
Patients who underwent OPCABG between January 2014 and January 2019 were included in the study. Preoperative and postoperative data retrospectively were obtained. Patients who did not develop PoAF during the postoperative hospitalization period constituted Group 1; those who did were classified as Group 2.
Ninety-seven patients (69 males and 28 females) with a mean age of 54.4 ± 11.1 years constituted Group 1, and 26 patients (17 males and 9 females) with a mean age of 61±12.6 years constituted Group 2. Significant differences were observed between the 2 groups, in terms of age and HATCH scores (P = .025 and P < .001, respectively). NLR, number of distal anastomoses, intensive care unit (ICU) stay times, and total hospitalization times were significantly higher in Group 2 (P = .021, P = .021, P < .001, P < .001, respectively). HATCH score was identified as an independent predictor of AF development following OPCABG surgery (OR: 2.125, 95 % CI: 1.296-3.482, P = .003).
In light of our study, HATCH scores of all patients preoperatively may be calculated so that preventive precautions are taken for high-risk patients.
背景：术后房颤（PoAF）是冠状动脉搭桥手术后18% - 40%患者中最常见的心律失常，可能导致血流动力学紊乱并增加栓塞风险。本研究旨在探讨心脏手术风险评估（HATCH）评分与非体外循环冠状动脉搭桥术（OPCABG）患者PoAF的关系，并评估术前计算的中性粒细胞与淋巴细胞比值（NLR）对PoAF的影响。
纳入2014年1月至2019年1月期间接受OPCABG的患者。回顾性获取术前和术后数据。术后住院期间未发生PoAF的患者构成第1组；发生PoAF的患者分为第2组。
第1组由97例患者（69例男性和28例女性）组成，平均年龄为54.4±11.1岁；第2组由26例患者（17例男性和9例女性）组成，平均年龄为61±12.6岁。两组在年龄和HATCH评分方面存在显著差异（分别为P = 0.025和P < 0.001）。第2组的NLR、远端吻合口数量、重症监护病房（ICU）停留时间和总住院时间显著更高（分别为P = 0.021、P = 0.021、P < 0.001、P < 0.001）。HATCH评分被确定为OPCABG手术后房颤发生的独立预测因素（OR：2.125，95%CI：1.296 - 3.482，P = 0.003）。
根据我们的研究，术前可计算所有患者的HATCH评分，以便对高危患者采取预防措施。
