Perioperative risk factors for new-onset postoperative atrial fibrillation after coronary artery bypass grafting: a systematic review

BMC Cardiovascular Disorders

Eun Ji Seo¹  Hyeon-Ju Lee²  Joonhwa Hong³  Youn-Jung Son⁴ 

[1] Ajou University College of Nursing and Research Institute of Nursing Science, 16499, Suwon, Republic of Korea;Department of Nursing, Tongmyoung University, 48520, Busan, Republic of Korea;Department of Thoracic and Cardiovascular Surgery, Chung-Ang University, 06974, Seoul, Republic of Korea;Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-Gu, 06974, Seoul, Republic of Korea;

关键词: Predictor;    Atrial fibrillation;    Coronary artery bypass graft;    Systematic review;   

DOI  :  10.1186/s12872-021-02224-x

来源: Springer

【 摘 要 】

BackgroundPostoperative atrial fibrillation (POAF) is the most common cardiac dysrhythmia to occur after coronary artery bypass grafting (CABG). However, the risk factors for new-onset POAF after CABG during the perioperative period have yet to be clearly defined. Accordingly, the aim of our systematic review was to evaluate the perioperative predictors of new-onset POAF after isolated CABG.MethodOur review methods adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. We searched seven electronic databases (PubMed, Embase, CINAHL, PsycArticles, Cochrane, Web of Science, and SCOPUS) to identify all relevant English articles published up to January 2020. Identified studies were screened independently by two researchers for selection, according to predefined criteria. The Newcastle–Ottawa Scale was used to evaluate the quality of studies retained.ResultsAfter screening, nine studies were retained for analysis, including 4798 patients, of whom 1555 (32.4%) experienced new-onset POAF after CABG. The incidence rate of new-onset POAF ranged between 17.3% and 47.4%. The following risk factors were identified: old age (p < 0.001), a high preoperative serum creatinine level (p = 0.001), a low preoperative hemoglobin level (p = 0.007), a low left ventricle ejection fraction in Asian patients (p = 0.001), essential hypertension (p < 0.001), chronic obstructive pulmonary disease (p = 0.010), renal failure (p = 0.009), cardiopulmonary bypass use (p = 0.002), perfusion time (p = 0.017), postoperative use of inotropes (p < 0.001), postoperative renal failure (p = 0.001), and re-operation (p = 0.005). All studies included in the analysis were of good quality.ConclusionsThe risk factors identified in our review could be used to improve monitoring of at-risk patients for early detection and treatment of new-onset POAF after CABG, reducing the risk of other complications and negative clinical outcomes.

【 授权许可】

CC BY