Analysis of risk factors for development of atrial fibrillation early after cardiac valvular surgery
Analysis of risk factors for development of atrial fibrillation early after cardiac valvular surgery
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DOI：
10.1016/s0002-9149(98)00498-6
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发表时间：
1998-10-01
影响因子：
2.8
通讯作者：
Chung, MK
中科院分区：
文献类型：
--
作者：
Asher, CR;Miller, DP;Chung, MK
心房颤动（AF）通常在心脏瓣膜手术后发生。本研究的目的是确定瓣膜手术后房颤的危险因素。分析了915例接受单独瓣膜手术且术前窦性心律的连续成人患者队列。确定术后房颤的单变量和独立多变量危险因素。第二个队列的305例患者具有相同的纳入标准，用于验证多变量预测因子。研究患者的平均年龄为56.1 ± 14.7岁，57.9%为男性，79.6%的患者左心室射血分数正常，平均左心房大小为46.2 ± 9.3 mm。术后AF的发生率为36.7%。术后房颤的独立预测因素包括：高龄（比值比[OR] 1.506/10，95%置信区间，[CI] 1.35 - 1.68，p = 0.0001）;二尖瓣狭窄（OR 2.066，CI 1.21至3.52，p = 0.0077）;左心房增大（OR 1.468，CI 1.07 - 2.01，p = 0.0165）;使用全身低温（OR 0.572，CI 0.422至0.776，p = 0.0003）;和心脏手术史（OR 0.676，CI 0.465至0.981，p = 0.0393）。在这些变量中，高龄、二尖瓣狭窄和左心房扩大在验证队列中被证实为独立的风险因素。（C）1998年由Excerpta Medica，Inc.
Atrial fibrillation (AF) commonly develops after cardiac valvular surgery. The objective of this study was to identify risk factors for postoperative AF following valvular surgery. A cohort of 915 consecutive adult patients undergoing isolated valvular surgery with preoperative sinus rhythm was analyzed. Univariate and independent multivariate risk factors for postoperative AF were determined. A second cohort of 305 patients with the same inclusion criteria was used to validate the multivariate predictors. Patients studied had a mean age of 56.1 +/- 14.7 years, 57.9% were men, 79.6% had a normal left ventricular ejection fraction, and their mean left atrial size was 46.2 +/- 9.3 mm. The incidence of postoperative AF was 36.7%. Independent predictors of postoperative AF included: advanced age (odds ratio [OR] 1.506 per decade, 95% confidence interval, [CI] 1.35 to 1.68, p = 0.0001); mitral stenosis (OR 2.066, CI 1.21 to 3.52, p = 0.0077); left atrial enlargement (OR 1.468, CI 1.07 to 2.01, p = 0.0165); use of systemic hypothermia (OR 0.572, CI 0.422 to 0.776, p = 0.0003); and a history of cardiac surgery (OR 0.676, CI 0.465 to 0.981, p = 0.0393). Among these variables, advanced age, mitral stenosis, and left atrial enlargement were confirmed as independent risk factors in the validation cohort. (C)1998 by Excerpta Medica, Inc.