D.J. Armagno1, S. Saha1 1University Of Kentucky, College Of Medicine, Department Of Cardiothoracic Surgery, Lexington, KY, USA
Introduction:
Post operative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG). This retrospective, observational study aims to examine the incidence and outcomes of POAF after CABG in our institution.
Methods:
Institutional Review Board approval was obtained for the retrospective review of patients who underwent CABG and developed POAF as a complication between 2006 and 2022. The study population includes patients who underwent first time CABG only, also excluding previous AF.
2671 patients (58.72 y/o, 29.97 BMI, m/f: 74.8% male, 93.1% white, 3.9% black, 2.9% other race/non-specified) were identified for this study. 238 patients (60.31 y/o, 29.45 BMI, m/f: 73.9% male, 92.9% white, 6.3% black, .8% other race/non-specified) developed POAF, while 2433 patients (58.56 y/o, 29.98 BMI, m/f: 74.9% male, 93.2% white, 3.7% black, 3.1% other race/non-specified) did not develop POAF.
The following outcomes were analyzed for this study: 30-day, 2-year, and 5-year mortality rates, hospital length of stay (LOS), intensive care unit (ICU) LOS, diagnosis of infection, post-operative bleeding, shock, embolism, renal failure, respiratory failure, sepsis, and stroke.
Results:
At our institution, POAF occurred in 8.9% of patients. Complications were also more prevalent in patients with POAF compared to those without. These included higher rates of infection (7.56% vs. 5.75%), post-operative bleeding (5.04% vs. 2.84%), renal failure (14.71% vs. 9.37%), and stroke (6.72% vs. 4.11%). Patients with POAF experienced a longer average LOS in both the ICU (5.26 days) and the hospital overall (10.94 days) compared to those without AF (ICU LOS: 5.18 days, hospital LOS: 10.25 days). The 30-day, 2-year, and 5-year mortality rates for patients who underwent CABG and developed AF were 1.3%, 7.8%, and 24%, respectively.
Conclusion:
Our study analyzed the impact of POAF on patient outcomes following CABG, including increased rates of complications and prolonged hospitalization/ICU stay. These findings emphasize the importance of monitoring and targeted intervention for AF after CABG.