Department of Cardiovascular Surgery, The Institute of Cardiovascular Diseases & TEDA International Cardiovascular Hospital, Tianjin University & Chinese Academy of Medical Sciences, Tianjin, China.
Tianjin Key Laboratory of Molecular Regulation of Cardiovascular Diseases and Translational Medicine, Tianjin, China.
Clin Cardiol. 2024 Oct;47(10):e24335. doi: 10.1002/clc.24335.
Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) that prolongs hospitalization and increases expenses.
Perioperative risk factors may predict POAF.
From March 2015 to January 2023, 6229 patients who underwent isolated CABG and were in sinus rhythm before CABG were included in this retrospective study. The preoperative and postoperative variants of patients were collected and analyzed by univariate analyses between the patients with and without POAF. Multivariate logistic regression analysis was then used to study the independent risk factors for POAF.
The incidence of POAF in this group of patients was 30.94%. Univariate analyses demonstrated that age (p < 0.001), hypertension (p < 0.001), smoking (p < 0.05), cardiopulmonary bypass (CPB) time (p < 0.01), and ejection fraction (EF, p < 0.01) were the risk factors for POAF. Multivariate logistic regression analysis determined the independent risk factors associated with POAF were old age (odds ratio [OR] = 1.062, p = 0.000) and low EF (OR = 0.980; p = 0.008).
In the current era, after isolated CABG surgery, there is still a quite high incidence of POAF (30.94% in this group of CABG patients). The main risk factors correlating to POAF include age, hypertension, smoking, CPB time, and EF. Among these factors, multivariate analysis identified old age and low EF as the independent risk factors associated with POAF. Particular care should be taken in the perioperative period for these patients in the prevention of POAF.
术后心房颤动（POAF）是冠状动脉旁路移植术（CABG）后的常见并发症，会延长住院时间并增加费用。
围手术期危险因素可能预测 POAF。
本回顾性研究纳入了 2015 年 3 月至 2023 年 1 月期间 6229 例接受单纯 CABG 且 CABG 前窦性心律的患者。通过 POAF 患者与无 POAF 患者之间的单变量分析，收集并分析了患者术前和术后的变量。然后使用多变量逻辑回归分析研究 POAF 的独立危险因素。
该组患者 POAF 的发生率为 30.94%。单变量分析表明，年龄（p<0.001）、高血压（p<0.001）、吸烟（p<0.05）、体外循环（CPB）时间（p<0.01）和射血分数（EF，p<0.01）是 POAF 的危险因素。多变量逻辑回归分析确定与 POAF 相关的独立危险因素是年龄大（优势比[OR] = 1.062，p = 0.000）和 EF 低（OR = 0.980；p = 0.008）。
在当前时代，在接受单纯 CABG 手术后，POAF 的发生率仍然相当高（本 CABG 患者组中为 30.94%）。与 POAF 相关的主要危险因素包括年龄、高血压、吸烟、CPB 时间和 EF。在这些因素中，多变量分析确定年龄大和 EF 低是与 POAF 相关的独立危险因素。在围手术期，应特别注意这些患者 POAF 的预防。
