New onset, post-op atrial fibrillation ups mortality

(HealthDay)—New onset postoperative atrial fibrillation (POAF) is associated with worse patient outcomes, including increased risk-adjusted mortality, according to a study published in the August issue of The Annals of Thoracic Surgery.

Damien J. LaPar, M.D., from the University of Virginia in Charlottesville, and colleagues examined the risk-adjusted impact of POAF. They extracted 49,264 patient records from a multi-institutional Society of Thoracic Surgeons (STS) certified database for cardiac operations, performed from 2001 to 2012, and characterized them according to the presence of POAF (19 percent) versus non-POAF (81 percent).

The researchers found that patients who developed POAF had higher mean age and median STS-predicted mortality risk (2 versus 1 percent; P < 0.001), compared with non-POAF patients. Patients undergoing aortic valve replacement plus coronary artery bypass grafting, aortic valve, and mitral valve replacement operations had the highest rate of POAF. POAF correlated with increased odds of mortality (adjusted odds ratio, 2.04; P < 0.001); greater hospital resource utilization; and increased costs after risk adjustment. In addition, POAF correlated with 48 additional intensive care unit hours, three extra hospital days, and increased intensive care unit and total hospital-related costs ($3,000 and $9,000, respectively; all P < 0.001).

"Protocols to reduce the incidence of POAF have the potential to significantly impact patient outcomes and the delivery of high-quality, cost-effective patient care," the authors write.