29 April 2008
Med Sci Monit 2008; 14(5): CR286-291 :: ID: 855756
Preoperative atrial fibrillation (AF) increases the risk of cardiac surgery and the occurrence of postoperative complications, including arrhythmias, low-output syndrome, delirium, and death. The aim was to evaluate its direct influence on prognosis of patients subjected to cardiac surgery.
Material and Method
This is a pilot study of the CODACS trial (COnsciousness Disorders After Cardiac Surgery). Two hundred sixty patients admitted for open-heart surgery were prospectively included in the study. Preoperative AF was diagnosed on the basis of multiple electrocardiographic examinations and confirmed by 24-h Holter monitoring. Diagnosis of delirium following surgical intervention was based on DSM-IV criteria.
Preoperative AF was diagnosed in 23 patients (8.8%): in 15 patients in the nondelirious group (7%) and 8 (27.0%) in the delirious group. Preoperative AF was an independent predictor of postoperative delirium (p<0.001), increasing its risk of occurrence over sevenfold (OR=7.2). AF also increased the risk of such postoperative complications as supraventricular arrhythmia (AF: 78.3% vs. non-AF: 22.8%, p<0.001), stroke (8.7% vs. 1.3%, p<0.001), and low-output syndrome (21.7% vs. 17.3%, p=0.033) and worsened prognosis, significantly increasing the risk of death (8.7% vs. 0.8%, p<0.001).
Preoperative AF was an independent risk factor of postoperative delirium (OR=7.2). It was also associated with significantly worse postoperative outcome (supraventricular arrhythmia, stroke, low-output syndrome, and risk of death). These results and data from available studies suggest that preoperative AF should be considered as an important predictor of postoperative outcome. This problem should be the subject of future research to establish beneficial treatment options.
Keywords: Risk Factors, Thoracic Surgery - methods, Prognosis, Postoperative Complications, Pilot Projects, Electrocardiography, Delirium - diagnosis, Atrial Fibrillation - diagnosis
18 October 2021 : EditorialEditorial: Global Initiatives Support the Use and Regulation of Digital Health Technology During the COVID-19 Pandemic
Med Sci Monit 2021; 27:e935123
20 October 2021 : EditorialEditorial: The 2021 European Society of Cardiology (ESC) Guidelines on the Real-World Prevention of Atheros...
Med Sci Monit In Press; DOI: 10.12659/MSM.935172
11 October 2021 : Clinical ResearchClinical Features and Temporal Lung Radiographic Changes in 25 Patients Recovering from COVID-19 Pneumonia:...
Med Sci Monit In Press; DOI: 10.12659/MSM.933381
08 September 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit In Press; DOI: 10.12659/MSM.932788
21 Oct 2021 : Database AnalysisConstruction and Verification of a Hypoxia-Stemness-Based Gene Signature for Risk Stratification in Esophag...
Med Sci Monit In Press; DOI: 10.12659/MSM.934359
21 Oct 2021 : Database AnalysisMS4A1 as a Potential Independent Prognostic Factor of Breast Cancer Related to Lipid Metabolism and Immune ...
Med Sci Monit In Press; DOI: 10.12659/MSM.934597
21 Oct 2021 : Clinical ResearchPredicting Values of Neutrophil-to-Lymphocyte Ratio (NLR), High-Sensitivity C-Reactive Protein (hs-CRP), an...
Med Sci Monit In Press; DOI: 10.12659/MSM.934569
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700