New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality

Background It is well established that postoperative atrial fibrillation (POAF) is associated with adverse postoperative outcomes after major cardiac operations. The purpose of this study was to investigate the incidence of new‐onset POAF after successful total arch repair surgery and the associatio...

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Autores principales:	Rui Zhao, Zhao Wang, Fangfang Cao, Jian Song, Shuya Fan, Juntao Qiu, Xiaohan Fan, Cuntao Yu
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	aortic disease aortic dissection arrhythmia atrial fibrillation Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/eee9156b069f46c3b78010d4ce7e814f
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spelling	oai:doaj.org-article:eee9156b069f46c3b78010d4ce7e814f2021-11-23T11:36:35ZNew‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality10.1161/JAHA.121.0219802047-9980https://doaj.org/article/eee9156b069f46c3b78010d4ce7e814f2021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021980https://doaj.org/toc/2047-9980Background It is well established that postoperative atrial fibrillation (POAF) is associated with adverse postoperative outcomes after major cardiac operations. The purpose of this study was to investigate the incidence of new‐onset POAF after successful total arch repair surgery and the association between POAF and in‐hospital mortality. Methods and Results All consecutive patients undergoing total arch repair from September 2012 to December 2019 in Fuwai hospital were enrolled (n=1280). Patients diagnosed with preoperative atrial fibrillation were excluded. POAF was diagnosed as the new‐onset atrial fibrillation or flutter for more than 5 minutes based on continuous electrocardiogram monitoring. A logistic regression model was used to determine predictors of in‐hospital mortality. Multivariable adjustment, inverse probability of treatment weighting, and propensity score matching were used to adjust for confounders. POAF was diagnosed in 32.3% (411/1271) of this cohort population. The occurrence of new‐onset POAF was associated with age (odds ratio [OR], 1.05; 95% CI, 1.04–1.06; P<0.001), male sex (OR, 0.72; 95% CI, 0.52–0.98; P=0.035), and surgery duration (OR, 1.2; 95% CI, 1.12–1.28; P<0.001). The in‐hospital mortality was significantly higher in patients with POAF than those without POAF (10.7% versus 2.4%, P<0.001). Inverse probability of treatment weighting and propensity score matching analyses confirmed the results. The increased in‐hospital mortality in POAF group still existed among subgroup analysis based on different age, sex, hypertension, smoking, and hypokalemia, combined with cardiac surgery, and deep hypothermic circulatory arrest. Conclusions More careful attention should be given to POAF after total arch repair surgery. The incidence of POAF after total arch repair surgery was 32.3% and associated with increased in‐hospital mortality. The elderly female patient who experienced longer operation duration was at highest risk for POAF.Rui ZhaoZhao WangFangfang CaoJian SongShuya FanJuntao QiuXiaohan FanCuntao YuWileyarticleaortic diseaseaortic dissectionarrhythmiaatrial fibrillationDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aortic disease aortic dissection arrhythmia atrial fibrillation Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	aortic disease aortic dissection arrhythmia atrial fibrillation Diseases of the circulatory (Cardiovascular) system RC666-701 Rui Zhao Zhao Wang Fangfang Cao Jian Song Shuya Fan Juntao Qiu Xiaohan Fan Cuntao Yu New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
description	Background It is well established that postoperative atrial fibrillation (POAF) is associated with adverse postoperative outcomes after major cardiac operations. The purpose of this study was to investigate the incidence of new‐onset POAF after successful total arch repair surgery and the association between POAF and in‐hospital mortality. Methods and Results All consecutive patients undergoing total arch repair from September 2012 to December 2019 in Fuwai hospital were enrolled (n=1280). Patients diagnosed with preoperative atrial fibrillation were excluded. POAF was diagnosed as the new‐onset atrial fibrillation or flutter for more than 5 minutes based on continuous electrocardiogram monitoring. A logistic regression model was used to determine predictors of in‐hospital mortality. Multivariable adjustment, inverse probability of treatment weighting, and propensity score matching were used to adjust for confounders. POAF was diagnosed in 32.3% (411/1271) of this cohort population. The occurrence of new‐onset POAF was associated with age (odds ratio [OR], 1.05; 95% CI, 1.04–1.06; P<0.001), male sex (OR, 0.72; 95% CI, 0.52–0.98; P=0.035), and surgery duration (OR, 1.2; 95% CI, 1.12–1.28; P<0.001). The in‐hospital mortality was significantly higher in patients with POAF than those without POAF (10.7% versus 2.4%, P<0.001). Inverse probability of treatment weighting and propensity score matching analyses confirmed the results. The increased in‐hospital mortality in POAF group still existed among subgroup analysis based on different age, sex, hypertension, smoking, and hypokalemia, combined with cardiac surgery, and deep hypothermic circulatory arrest. Conclusions More careful attention should be given to POAF after total arch repair surgery. The incidence of POAF after total arch repair surgery was 32.3% and associated with increased in‐hospital mortality. The elderly female patient who experienced longer operation duration was at highest risk for POAF.
format	article
author	Rui Zhao Zhao Wang Fangfang Cao Jian Song Shuya Fan Juntao Qiu Xiaohan Fan Cuntao Yu
author_facet	Rui Zhao Zhao Wang Fangfang Cao Jian Song Shuya Fan Juntao Qiu Xiaohan Fan Cuntao Yu
author_sort	Rui Zhao
title	New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
title_short	New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
title_full	New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
title_fullStr	New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
title_full_unstemmed	New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
title_sort	new‐onset postoperative atrial fibrillation after total arch repair is associated with increased in‐hospital mortality
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/eee9156b069f46c3b78010d4ce7e814f
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New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality

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