Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
Acupuncture and Moxibustion School of Teaching Hospital of Chengdu University of TCM, Chengdu, China.
Ann Thorac Cardiovasc Surg. 2023 Dec 20;29(6):287-293. doi: 10.5761/atcs.oa.23-00074. Epub 2023 Jun 23.
We aimed to determine if sleep disorders before cardiac surgery indicate an increased risk of postoperative atrial fibrillation (POAF).
In this study, 238 patients undergoing coronary artery bypass grafting in our center were included. Patients were separated into the preoperative sleep disorder group and the control group. The primary endpoint was the incidence of POAF, and the secondary endpoints were the incidence of postoperative stroke, duration of invasive ventilation, length of intensive care unit, and hospitalization stay. Propensity score matching and multivariable logistic regression were used for adjusting potential confounders.
A total of 165 (69.3%) patients had sleep disorders before surgery, and 73 well-matched pairs were generated. A higher incidence of POAF was found in the preoperative sleep disorder group (16.4% versus 5.5%, p = 0.034). In multivariable logistic regression, preoperative sleep disorders were correlated to a higher risk of POAF (odds ratio = 4.627, 95% confidence interval: 1.181-18.123, p = 0.028). In the subgroup of patients without long-term sleep disorders, those who experienced preoperative sleep disorders had a higher incidence of POAF (16.1% versus 4.3%, p = 0.024), meanwhile, no difference was found in the subgroup of long-term sleep disorders.
New-onset sleep disorders before cardiac surgery may indicate a higher incidence of POAF.
我们旨在确定心脏手术前的睡眠障碍是否预示着术后心房颤动（POAF）的风险增加。
本研究纳入了在我院行冠状动脉旁路移植术的 238 例患者。将患者分为术前睡眠障碍组和对照组。主要终点是 POAF 的发生率，次要终点是术后中风、有创通气时间、重症监护病房时间和住院时间。采用倾向评分匹配和多变量逻辑回归调整潜在混杂因素。
共有 165 例（69.3%）患者术前存在睡眠障碍，匹配了 73 对。术前睡眠障碍组 POAF 发生率较高（16.4%比 5.5%，p = 0.034）。多变量逻辑回归显示，术前睡眠障碍与 POAF 的发生风险增加相关（优势比=4.627，95%置信区间：1.181-18.123，p = 0.028）。在无长期睡眠障碍的患者亚组中，术前存在睡眠障碍的患者 POAF 发生率更高（16.1%比 4.3%，p = 0.024），而长期睡眠障碍的患者亚组中无差异。
心脏手术前新发睡眠障碍可能预示着 POAF 的发生率更高。
