초록접수 현황
| 20F-067 | 구연 발표 |
Long-term outcomes of preoperative atrial fibrillation on cardiac surgery
Hyo-Hyun Kim, Sak Lee, Jung-Hwan Kim, Hyun-Chel Joo, Young-Nam Youn, Kyung-Jong Yoo, Seung Hyun Lee
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul 03722, Korea
Purpose : Atrial fibrillation (Afib) is a marker for increased cardiovascular morbidity and mortality. Owing to increased prevalence of Afib in patients undergoing cardiac surgery, assessment of the potential effect of arrhythmia on postsurgical outcome using a large surgical database is important. We aimed to analyze the effect of preoperative atrial fibrillation (Afib) on clinical outcomes in patients undergoing cardiac surgery.
Methods : This retrospective cohort study is based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th Revision.
Results : We included 1,037 patients (0.1%) from a randomized 1,000,000 patient cohort who had undergone cardiac surgery, while 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of 1037 patients who underwent cardiac surgery, 412 (39.7%), 303 (29.2%), and 106 (10.4%) underwent coronary artery bypass, heart valve surgery, and Cox-Maze surgery, respectively. Preoperative Afib was associated with higher mortality (p=0.028), regardless of operation type. Preoperative Afib patients (190, 18.6%) experienced a higher cumulative risk of overall mortality (HR 1.435, 95% CI 0.953-2.161, p=0.034). Subgroup Cox regression analysis revealed a significant survival difference between concomitant Cox-Maze operation and none (HR 0.386, 95% CI 0.198-0.753, p=0.005). Postoperative cerebral ischemia or hemorrhage events were not related with Afib.
Conclusion : Preoperative Afib is independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-Maze operation could result in improved survival rates.
Methods : This retrospective cohort study is based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th Revision.
Results : We included 1,037 patients (0.1%) from a randomized 1,000,000 patient cohort who had undergone cardiac surgery, while 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of 1037 patients who underwent cardiac surgery, 412 (39.7%), 303 (29.2%), and 106 (10.4%) underwent coronary artery bypass, heart valve surgery, and Cox-Maze surgery, respectively. Preoperative Afib was associated with higher mortality (p=0.028), regardless of operation type. Preoperative Afib patients (190, 18.6%) experienced a higher cumulative risk of overall mortality (HR 1.435, 95% CI 0.953-2.161, p=0.034). Subgroup Cox regression analysis revealed a significant survival difference between concomitant Cox-Maze operation and none (HR 0.386, 95% CI 0.198-0.753, p=0.005). Postoperative cerebral ischemia or hemorrhage events were not related with Afib.
Conclusion : Preoperative Afib is independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-Maze operation could result in improved survival rates.
책임저자: Seung Hyun Lee
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul 03722, Korea
발표자: Hyo-Hyun Kim, E-mail : ysgs@yuhs.ac