Duration of Postoperative Atrial Fibrillation After Cardiac Surgery Is Associated With Worsened Long-Term Survival

Martin I. Sigurdsson, Nicholas T. Longford, Mahyar Heydarpour, Louis Saddic, Tzuu Wang Chang, Amanda A. Fox, Charles D. Collard, Sary Aranki, Prem Shekar, Stanton K. Shernan, Jochen D. Muehlschlegel, Simon C. Body

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Studies of the effects of postoperative atrial fibrillation (poAF) on long-term survival are conflicting, likely because of comorbidities that occur with poAF and the patient populations studied. Furthermore, the effects of poAF duration on long-term survival are poorly understood. Methods We utilized a prospectively collected database on outcomes of cardiac surgery at a large tertiary care institution between August 2001 and December 2010 with survival follow-up through June 2015 to analyze long-term survival of patients with poAF. In addition, we identified patient- and procedure-related variables associated with poAF, and estimated overall comorbidity burden using the Elixhauser comorbidity index. Survival was compared between patients with poAF (n = 513) and a propensity score matched control cohort, both for all patients and separately for subgroups of patients with poAF lasting less than 2 days (n = 218) and patients with prolonged poAF (n = 265). Results Patients with poAF were older and had a higher burden of comorbidities. Survival was significantly worse for patients with poAF than for the matched control group (hazard ratio 1.43, 95% confidence interval: 1.11 to 1.86). That was driven by decreased survival among patients with prolonged poAF (hazard ratio 1.97, 95% confidence interval: 1.37 to 2.80), whereas survival of patients with poAF for less than 2 days was not significantly different from that of matched controls (hazard ratio 0.91, 95% confidence interval: 0.60 to 1.39). Conclusions After close matching based on comorbidity burden, prolonged poAF is still associated with decreased survival. Therefore, vigilance is warranted in monitoring and treating patients with prolonged poAF after cardiac surgery.

Original languageEnglish (US)
Pages (from-to)2018-2026
Number of pages9
JournalAnnals of Thoracic Surgery
Volume102
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Atrial Fibrillation
Thoracic Surgery
Survival
Comorbidity
Confidence Intervals
Safety Management
Propensity Score
Physiologic Monitoring
Tertiary Healthcare
Research Design
Databases

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Duration of Postoperative Atrial Fibrillation After Cardiac Surgery Is Associated With Worsened Long-Term Survival. / Sigurdsson, Martin I.; Longford, Nicholas T.; Heydarpour, Mahyar; Saddic, Louis; Chang, Tzuu Wang; Fox, Amanda A.; Collard, Charles D.; Aranki, Sary; Shekar, Prem; Shernan, Stanton K.; Muehlschlegel, Jochen D.; Body, Simon C.

In: Annals of Thoracic Surgery, Vol. 102, No. 6, 01.12.2016, p. 2018-2026.

Research output: Contribution to journalArticle

Sigurdsson, MI, Longford, NT, Heydarpour, M, Saddic, L, Chang, TW, Fox, AA, Collard, CD, Aranki, S, Shekar, P, Shernan, SK, Muehlschlegel, JD & Body, SC 2016, 'Duration of Postoperative Atrial Fibrillation After Cardiac Surgery Is Associated With Worsened Long-Term Survival', Annals of Thoracic Surgery, vol. 102, no. 6, pp. 2018-2026. https://doi.org/10.1016/j.athoracsur.2016.05.016
Sigurdsson, Martin I. ; Longford, Nicholas T. ; Heydarpour, Mahyar ; Saddic, Louis ; Chang, Tzuu Wang ; Fox, Amanda A. ; Collard, Charles D. ; Aranki, Sary ; Shekar, Prem ; Shernan, Stanton K. ; Muehlschlegel, Jochen D. ; Body, Simon C. / Duration of Postoperative Atrial Fibrillation After Cardiac Surgery Is Associated With Worsened Long-Term Survival. In: Annals of Thoracic Surgery. 2016 ; Vol. 102, No. 6. pp. 2018-2026.
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abstract = "Background Studies of the effects of postoperative atrial fibrillation (poAF) on long-term survival are conflicting, likely because of comorbidities that occur with poAF and the patient populations studied. Furthermore, the effects of poAF duration on long-term survival are poorly understood. Methods We utilized a prospectively collected database on outcomes of cardiac surgery at a large tertiary care institution between August 2001 and December 2010 with survival follow-up through June 2015 to analyze long-term survival of patients with poAF. In addition, we identified patient- and procedure-related variables associated with poAF, and estimated overall comorbidity burden using the Elixhauser comorbidity index. Survival was compared between patients with poAF (n = 513) and a propensity score matched control cohort, both for all patients and separately for subgroups of patients with poAF lasting less than 2 days (n = 218) and patients with prolonged poAF (n = 265). Results Patients with poAF were older and had a higher burden of comorbidities. Survival was significantly worse for patients with poAF than for the matched control group (hazard ratio 1.43, 95{\%} confidence interval: 1.11 to 1.86). That was driven by decreased survival among patients with prolonged poAF (hazard ratio 1.97, 95{\%} confidence interval: 1.37 to 2.80), whereas survival of patients with poAF for less than 2 days was not significantly different from that of matched controls (hazard ratio 0.91, 95{\%} confidence interval: 0.60 to 1.39). Conclusions After close matching based on comorbidity burden, prolonged poAF is still associated with decreased survival. Therefore, vigilance is warranted in monitoring and treating patients with prolonged poAF after cardiac surgery.",
author = "Sigurdsson, {Martin I.} and Longford, {Nicholas T.} and Mahyar Heydarpour and Louis Saddic and Chang, {Tzuu Wang} and Fox, {Amanda A.} and Collard, {Charles D.} and Sary Aranki and Prem Shekar and Shernan, {Stanton K.} and Muehlschlegel, {Jochen D.} and Body, {Simon C.}",
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T1 - Duration of Postoperative Atrial Fibrillation After Cardiac Surgery Is Associated With Worsened Long-Term Survival

AU - Sigurdsson, Martin I.

AU - Longford, Nicholas T.

AU - Heydarpour, Mahyar

AU - Saddic, Louis

AU - Chang, Tzuu Wang

AU - Fox, Amanda A.

AU - Collard, Charles D.

AU - Aranki, Sary

AU - Shekar, Prem

AU - Shernan, Stanton K.

AU - Muehlschlegel, Jochen D.

AU - Body, Simon C.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Background Studies of the effects of postoperative atrial fibrillation (poAF) on long-term survival are conflicting, likely because of comorbidities that occur with poAF and the patient populations studied. Furthermore, the effects of poAF duration on long-term survival are poorly understood. Methods We utilized a prospectively collected database on outcomes of cardiac surgery at a large tertiary care institution between August 2001 and December 2010 with survival follow-up through June 2015 to analyze long-term survival of patients with poAF. In addition, we identified patient- and procedure-related variables associated with poAF, and estimated overall comorbidity burden using the Elixhauser comorbidity index. Survival was compared between patients with poAF (n = 513) and a propensity score matched control cohort, both for all patients and separately for subgroups of patients with poAF lasting less than 2 days (n = 218) and patients with prolonged poAF (n = 265). Results Patients with poAF were older and had a higher burden of comorbidities. Survival was significantly worse for patients with poAF than for the matched control group (hazard ratio 1.43, 95% confidence interval: 1.11 to 1.86). That was driven by decreased survival among patients with prolonged poAF (hazard ratio 1.97, 95% confidence interval: 1.37 to 2.80), whereas survival of patients with poAF for less than 2 days was not significantly different from that of matched controls (hazard ratio 0.91, 95% confidence interval: 0.60 to 1.39). Conclusions After close matching based on comorbidity burden, prolonged poAF is still associated with decreased survival. Therefore, vigilance is warranted in monitoring and treating patients with prolonged poAF after cardiac surgery.

AB - Background Studies of the effects of postoperative atrial fibrillation (poAF) on long-term survival are conflicting, likely because of comorbidities that occur with poAF and the patient populations studied. Furthermore, the effects of poAF duration on long-term survival are poorly understood. Methods We utilized a prospectively collected database on outcomes of cardiac surgery at a large tertiary care institution between August 2001 and December 2010 with survival follow-up through June 2015 to analyze long-term survival of patients with poAF. In addition, we identified patient- and procedure-related variables associated with poAF, and estimated overall comorbidity burden using the Elixhauser comorbidity index. Survival was compared between patients with poAF (n = 513) and a propensity score matched control cohort, both for all patients and separately for subgroups of patients with poAF lasting less than 2 days (n = 218) and patients with prolonged poAF (n = 265). Results Patients with poAF were older and had a higher burden of comorbidities. Survival was significantly worse for patients with poAF than for the matched control group (hazard ratio 1.43, 95% confidence interval: 1.11 to 1.86). That was driven by decreased survival among patients with prolonged poAF (hazard ratio 1.97, 95% confidence interval: 1.37 to 2.80), whereas survival of patients with poAF for less than 2 days was not significantly different from that of matched controls (hazard ratio 0.91, 95% confidence interval: 0.60 to 1.39). Conclusions After close matching based on comorbidity burden, prolonged poAF is still associated with decreased survival. Therefore, vigilance is warranted in monitoring and treating patients with prolonged poAF after cardiac surgery.

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U2 - 10.1016/j.athoracsur.2016.05.016

DO - 10.1016/j.athoracsur.2016.05.016

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C2 - 27424470

AN - SCOPUS:84995962629

VL - 102

SP - 2018

EP - 2026

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

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