Borzak S, Tisdale J E, Amin N B, Goldberg A D, Frank D, Padhi I D, Higgins R S
Division of Cardiology, Henry Ford Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI 48202, USA.
Chest. 1998 Jun;113(6):1489-91. doi: 10.1378/chest.113.6.1489.
The goal of this study was to determine whether prolonged hospital stay associated with atrial fibrillation or flutter (AF) after coronary artery bypass graft (CABG) surgery is attributable to the characteristics of patients who develop this arrhythmia or to the rhythm disturbance itself.
An investigation was conducted through a prospective case series.
Patients were from a single urban teaching hospital.
Consecutive patients undergoing isolated CABG surgery between December 1994 and May 1996 were included in the study.
No interventions were involved.
Of 436 patients undergoing isolated CABG surgery, 101 (23%) developed AF. AF patients were older and more likely to have obstructive lung disease than patients without AF, but both patients with and without AF had similar left ventricular function and extent of coronary disease. ICU and hospital stays were longer in patients with AF. Multivariate analysis, adjusted for age, gender, and race, demonstrated that postoperative hospital stay was 9.2+/-5.3 days in patients with AF and 6.4+/-5.3 days in patients without AF (p<0.001).
Although AF is strongly associated with advanced age, most of the prolonged hospital stay appears to be attributable to the rhythm itself and not to patient characteristics.
本研究的目的是确定冠状动脉搭桥术（CABG）后与房颤或房扑（AF）相关的住院时间延长是由于发生这种心律失常的患者特征所致，还是由于节律紊乱本身所致。
通过前瞻性病例系列进行调查。
患者来自一家城市教学医院。
纳入了1994年12月至1996年5月期间连续接受单纯CABG手术的患者。
未涉及干预措施。
在436例接受单纯CABG手术的患者中，101例（23%）发生了AF。与无AF的患者相比，AF患者年龄更大，更有可能患有阻塞性肺病，但有AF和无AF的患者左心室功能和冠状动脉病变程度相似。AF患者的重症监护病房（ICU）和住院时间更长。在对年龄、性别和种族进行调整的多变量分析中，AF患者的术后住院时间为9.2±5.3天，无AF患者为6.4±5.3天（p<0.001）。
虽然AF与高龄密切相关，但住院时间延长似乎大多归因于节律本身，而非患者特征。
