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Published on: July 20, 2022
Predictive factors of atrial fibrillation after coronary artery bypass grafting
Cynthia de Oliveira Folla1, Cinthia Cristina de Santana Melo2, Rita de Cassia Gengo E Silva2
1Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Insights
Advanced age and enlarged left atrial diameter are key predictors of postoperative atrial fibrillation following coronary artery bypass grafting surgery. These findings aid in identifying high-risk patients for targeted interventions.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Informatics
Background:
- Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery.
- Identifying predictive factors for POAF is crucial for patient management and risk stratification.
- Coronary artery bypass grafting (CABG) is a major cardiac procedure where POAF incidence can be significant.
Purpose of the Study:
- To identify demographic and perioperative variables that predict the occurrence of POAF in patients undergoing exclusively CABG.
- To analyze the association between patient characteristics and the development of POAF within the first three days post-surgery.
Main Methods:
- Retrospective cohort study of 105 patients who underwent isolated CABG in 2014.
- Data collection included demographic, preoperative, and immediate postoperative clinical variables.
- A decision tree model using the Classification and Regression Trees (CART) algorithm was employed to identify predictive factors for POAF.
Main Results:
- The incidence of POAF was 19.0% (20 out of 105 patients).
- Patients with a left atrial diameter greater than 40.5 mm were significantly more likely to develop POAF.
- Individuals older than 64.5 years also showed a higher probability of developing this post-surgical arrhythmia.
Conclusions:
- Left atrial diameter and advanced age are significant predictive factors for POAF in patients undergoing CABG.
- These findings can assist in the preoperative assessment and risk stratification of patients undergoing this procedure.
Objective:
To analyze predictive demographic and perioperative variables of postoperative atrial fibrillation in patients who underwent exclusively coronary artery bypass grafting.
Methods:
This was a retrospective cohort. We randomly selected 105 medical records of patients who underwent exclusively coronary artery bypass grafting in 2014. Demographic, clinical (preoperative and immediate postoperative) data and related with surgical procedure were collected from medical records. The occurrence of postoperative atrial fibrillation was considered until the third day after the surgery. Variables were analyzed using descriptive and inferential statistics. To identify predictive factors of postoperative atrial fibrillation we used a decision tree model with Classification and Regression Trees algorithm.
Results:
Atrial fibrillation incidence was 19.0% (n=20). Patients with left atrial >40.5mm and aged >64.5 years were more likely to develop the arrhythmia during the post-surgical period.
Conclusion:
Left atrial diameter and advanced age were predictive factors of atrial fibrillation in patients who underwent exclusively coronary artery bypass grafting.
Objetivo:
Analisar as variáveis demográficas e perioperatórias preditivas de fibrilação atrial pós-operatória em pacientes brasileiros submetidos exclusivamente à cirurgia de revascularização do miocárdio.
MéTodos:
Trata-se de coorte retrospectiva. A amostra foi constituída de 105 prontuários de pacientes submetidos exclusivamente à revascularização do miocárdio no ano de 2014, selecionados aleatoriamente. Dados demográficos, clínicos (préoperatórios e do pós-operatório imediato) e relacionados ao procedimento cirúrgico foram coletados por meio de consulta ao prontuário. A ocorrência de fibrilação atrial no pós-operatório foi considerada até o terceiro dia após a cirurgia. As variáveis foram analisadas por estatística descritiva e inferencial. Para identificar os fatores preditivos de fibrilação atrial no pós-operatório, utilizou-se um modelo de árvore de decisão com algoritmo Classification and Regression Trees.
Resultados:
A incidência de fibrilação atrial pós-operatória foi de 19,0% (n=20). Pacientes com átrio esquerdo >40,5mm e idade >64,5 anos foram aqueles com mais chance de desenvolver a arritmia no pós-operatório.
ConclusãO:
Tamanho do átrio esquerdo e idade avançada foram fatores preditivos de fibrilação atrial em pacientes submetidos exclusivamente à cirurgia de revascularização do miocárdio.
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