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Perioperative risk factors for new-onset postoperative atrial fibrillation among patients after isolated coronary artery bypass grafting: A retrospective study

Authors
Choi, Hong-JaeSeo, Eun JiChoi, Jae-SungOh, Se JinSon, Youn-Jung
Issue Date
May-2022
Publisher
John Wiley and Sons Inc
Keywords
atrial fibrillation; coronary artery bypass grafting; nurses; nursing; perioperative period; risk assessment
Citation
Journal of Advanced Nursing, v.78, no.5, pp 1317 - 1326
Pages
10
Journal Title
Journal of Advanced Nursing
Volume
78
Number
5
Start Page
1317
End Page
1326
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/49909
DOI
10.1111/jan.15045
ISSN
0309-2402
1365-2648
Abstract
Aims: Incidence of atrial fibrillation is considerably high after open heart surgery, which may prolong hospitalization and increase mortality. The aim of the present study is to investigate the perioperative risk factors for the occurrence of new-onset atrial fibrillation following isolated coronary artery bypass grafting. Design: A retrospective study. Methods: A total of 327 Korean patients recorded to have undergone first-time isolated coronary artery bypass grafting and no preoperative history of atrial fibrillation were included. The data were obtained from electronic health record from January 2010 to December 2019 at a tertiary care hospital. Predictors of new-onset atrial fibrillation after the surgery were identified by multivariate logistic regression analysis. Results: The incidence rate of new-onset atrial fibrillation after coronary artery bypass grafting was approximately 28.4%, and the highest occurrence rate was 44.1% on postoperative day 2. Our main finding showed that advanced age was the strongest predictor of atrial fibrillation after coronary artery bypass grafting. In addition, history of stroke and depression, chronic obstructive pulmonary disease and intraoperative use of intra-aortic balloon pump were shown to be the risk factors. Conclusion: Our findings showed that approximately 28% patients had new-onset atrial fibrillation after the surgery. Healthcare professionals should proactively assess risk factors for postoperative atrial fibrillation and focus more on older adults with pre-existing comorbidities, such as stroke, depression and chronic obstructive pulmonary disease. Impact: Older adults with history of stroke, depression and comorbid chronic obstructive pulmonary disease should be carefully monitored closely during perioperative period. The study highlights that early assessment of new-onset postoperative atrial fibrillation can contribute to promote the quality of nursing care and frontline nurses may be a vital role in timely detection of atrial fibrillation after surgery. Prospective studies are required to identify the mechanisms connecting perioperative risk factors for atrial fibrillation after cardiac surgery. © 2021 John Wiley & Sons Ltd
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적십자간호대학 (간호학과)
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