School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
Intensive Crit Care Nurs. 2020 Oct;60:102897. doi: 10.1016/j.iccn.2020.102897. Epub 2020 Jun 26.
To estimate the incidence of new-onset post-operative atrial fibrillation after isolated coronary artery bypass surgery and summarise the evidence on risk factors that predispose people to developing the complication.
STUDY DESIGN/METHODS: A systematic review was conducted to identify studies from the CINAHL, MEDLINE and Cochrane databases. A title and abstract review was conducted by one reviewer. Full text review and quality assessment processes were conducted by two reviewers. Incidence data was combined in meta-analysis using the 'metaprop' routine in Stata and risk factor data were synthesised in narrative and table format.
Ten studies, including 6173 participants, were included in the review. The estimated pooled incidence of post-operative atrial fibrillation was 25% (CI 0.19-0.30). In a secondary meta-analysis including studies that only included first time bypass surgery recipients the estimated pooled incidence was 26% (CI 0.14-0.41). Due to high levels of heterogeneity these results should be interpreted with caution. Risk factors with the strongest associations to post-operative atrial fibrillation were chronic obstructive pulmonary disease, decreased partial pressure of oxygen on air, congestive heart failure, right coronary artery disease, male gender, prolonged cross clamp time and port-operative inotropic exposure.
Further prospective studies are needed to strengthen the current evidence base.
评估孤立性冠状动脉旁路手术后新发术后心房颤动的发生率，并总结易发生该并发症的危险因素的证据。
研究设计/方法：系统评价旨在从 CINAHL、MEDLINE 和 Cochrane 数据库中识别研究。由一名审查员进行标题和摘要审查。两名审查员进行全文审查和质量评估。使用 Stata 中的“metaprop”例程对发生率数据进行荟萃分析，并以叙述和表格形式综合风险因素数据。
10 项研究，包括 6173 名参与者，被纳入综述。术后心房颤动的估计合并发生率为 25%（CI 0.19-0.30）。在包括仅接受首次旁路手术的研究的二次荟萃分析中，估计的合并发生率为 26%（CI 0.14-0.41）。由于存在高度异质性，这些结果应谨慎解释。与术后心房颤动关联最强的危险因素是慢性阻塞性肺疾病、空气下氧分压降低、充血性心力衰竭、右冠状动脉疾病、男性、体外循环时间延长和术后正性肌力药物暴露。
需要进一步的前瞻性研究来加强当前的证据基础。
