Mortality and Cost of Post-Operative Atrial Fibrillation After Major Non-Cardiac Surgery

Bhave, Prashant D.; Goldman, L. Elizabeth; Vittinghoff, Eric; Maselli, Judith; Auerbach, Andrew D.

doi:10.1016/s0735-1097(11)61236-9

Cited by 3 publications

(2 citation statements)

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“…New-onset postoperative atrial fibrillation (POAF) is the most commonly occurred arrhythmia in patients after surgery [1]. The reported incidence varies widely, from 0.39% to 29%, according to the patient populations and the types of surgeries [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. In our previous study, 2.7% of patients admitted to the intensive care unit (ICU) after non-cardiac surgery developed new-onset POAF.…”

Section: Introductionmentioning

confidence: 99%

“…In patients after cardiac surgery, newonset POAF is associated with increased hospital readmission, late atrial fibrillation (AF) and thromboembolic disease, as well as long-term mortality [16][17][18][19][20][21]. In patients after major non-cardiac surgery, new-onset POAF is reported to be associated with higher in-hospital mortality, longer hospital stays, higher health care costs [9], and increased long-term cardiovascular events (including acute myocardial infarction and stroke) [10,12,13]. In a recent prospective cohort study of ICU patients (including surgical patients), new-onset AF is associated with increased 1-year mortality [22].…”

Section: Introductionmentioning

confidence: 99%

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New-onset postoperative atrial fibrillation is associated with worse long-term outcome in critically ill patients after non-cardiac surgery: 3-year follow-up of a case-control study

Xie

Pan

et al. 2019

Preprint

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Background The impact of new-onset postoperative atrial fibrillation (POAF) on long-term outcomes of patients after non-cardiac surgery remains controversial. Here we report the 3-year follow-up of a previous case-control study to determine the relationship between new-onset POAF and long-term outcomes in patients after non-cardiac surgery. Methods In a previous case-control study, 213 patients who were admitted to the intensive care unit (ICU) after non-cardiac surgery were included; of them 71 were in the POAF group and 142 the control group. A telephone interview was performed with patients or their family members at 3 years after surgery. The primary endpoint was the incidence of major adverse cardiovascular events (MACEs) within 3 years, including cardiovascular death, non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, and ischemic stroke. A logistic regression model was established to assess the association between the occurrence of new-onset POAF and the development of 3-year MACEs. Results 202 patients completed the 3-year follow-up and were included in the analysis; of them 68 were in the POAF group and 134 were in the control group. The incidence of 3-year MACEs was higher in the POAF group than in the control group (64.7% [44/68] vs. 23.1% [31/134], p<0.001). After correction for confounding factors, new-onset POAF was independently associated with an increased risk of 3-year MACEs (odds ratio 5.448, 95% confidence interval 2.202-13.481, p<0.001). Conclusions For adult patients admitted to the ICU after non-cardiac surgery, new-onset POAF was an independent risk factor for the development of MACEs within 3 years.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

New-onset postoperative atrial fibrillation is associated with worse long-term outcome in critically ill patients after non-cardiac surgery: 3-year follow-up of a case-control study

Xie

Pan

et al. 2019

Preprint

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Incorporating Intra-Operative Medication Information for Prediction of Post-Operative Atrial Fibrillation

Johnson

Deng

et al. 2019

2019 IEEE International Conference on Healthcare Informatics (ICHI)

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Significance of Intraoperative Medication Data and Model Selection for Predicting Postoperative First-Time Atrial Fibrillation

Yu¹,

Johnson²,

Deng³

et al. 2023

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Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and has a well-established association with coronary artery bypass graft (CABG) surgery. Being able to predict post-operative atrial fibrillation (POAF) may improve surgical outcomes. This study aims to understand the efficacy of incorporating intraoperative medication data to predict first-time POAF in patients undergoing CABG surgery. Methods This study aims to understand the efficacy of incorporating intraoperative medication data to predict first-time POAF in patients undergoing CABG surgery. A large cohort of 3807 first-time CABG patients with no known history of atrial fibrillation was retrospectively assembled to study factors that contribute to occurrence of post-operative atrial fibrillation, in addition to testing models that may predict its incidence. To do so, several clinical features with established relevance to POAF were extracted from the electronic health record, along with a record of medications administered intra-operatively. Tests of performance with logistic regression, decision tree, and neural network predictive models showed slight improvements when incorporating medication information. Results Analysis of the collected set of clinical and medications data indicate that there may be effects contributing to POAF incidence captured in the medication administration records. However, a definitive causal relationship between the medications and POAF incidence is not established. Conclusions Our results show that improved predictive performance is achievable by incorporating a record of medications administered intra-operatively, but further investigation is needed to understand the implications of this for clinical practice.

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Mortality and Cost of Post-Operative Atrial Fibrillation After Major Non-Cardiac Surgery

Cited by 3 publications

References 0 publications

New-onset postoperative atrial fibrillation is associated with worse long-term outcome in critically ill patients after non-cardiac surgery: 3-year follow-up of a case-control study

New-onset postoperative atrial fibrillation is associated with worse long-term outcome in critically ill patients after non-cardiac surgery: 3-year follow-up of a case-control study

Incorporating Intra-Operative Medication Information for Prediction of Post-Operative Atrial Fibrillation

Significance of Intraoperative Medication Data and Model Selection for Predicting Postoperative First-Time Atrial Fibrillation

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