August 14, 2014
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Postoperative AF associated with higher mortality risk, hospital costs

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Postoperative atrial fibrillation was linked with increased mortality risk, hospital costs and rates of hospital readmission in a new study.

Researchers collected data on 49,264 patients (mean age, 64 years) from the Virginia Cardiac Surgery Quality Initiative, a cooperative of 17 cardiac surgery centers in Virginia that is linked to the Society of Thoracic Surgeons (STS) database. Data were acquired from Jan. 1, 2001, through Dec. 31, 2012. Researchers stratified patient records based on the incidence of postoperative AF.

Primary outcomes included risk-adjusted associations between postoperative AF and operative mortality, morbidity, length of hospital stay and hospital costs.

Postoperative AF occurred in 18.8% of patients studied. Patients who developed AF had a higher STS-predicted mortality risk compared with those who did not develop AF (2% vs. 1%; P<.001). AF rates were highest among patients who underwent aortic or mitral valve replacement, or aortic valve replacement with CABG.

Among patients with postoperative AF, researchers observed a higher unadjusted risk for all primary outcomes, in addition to increased risk for operative mortality (4% vs. 1.7%; P<.001). After adjustment for confounders, AF was associated with a two times greater risk for mortality, greater use of hospital resources and increased costs. Postoperative AF was also associated with an additional 48 hours in the ICU and 3 additional days of hospital stay, as well as an additional $3,000 in ICU costs and $9,000 in total hospital costs (P< .001 for all).

Damien J. LaPar, MD

Damien J. LaPar

According to Damien J. LaPar, MD, from the University of Virginia in Charlottesville, the stroke rate among patients with postoperative AF was 2.6%.

“At a time when quality of patient care is under increasing scrutiny, developing protocols designed to reduce the incidence of postoperative AF has the potential to impact patient outcomes and result in the delivery of high-quality, cost-effective patient care,” LaPar said in a press release.

Disclosure: One researcher reported a financial relationship with Medtronic. LaPar reports no relevant financial disclosures.