Clinical Risk Factors for Postoperative Atrial Fibrillation among Patients after Cardiac Surgery.
Clinical Risk Factors for Postoperative Atrial Fibrillation among Patients after Cardiac Surgery.
复制标题
DOI：
10.1055/s-0038-1667065
复制
发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Dosdall DJ
中科院分区：
文献类型：
--
作者：
Yamashita K;Hu N;Ranjan R;Selzman CH;Dosdall DJ
术后房颤（POAF）是心脏手术后常见的心律失常，与医疗费用、并发症和死亡率增加相关。POAF的病因尚未完全了解，其预测仍然不理想。利用已发表研究的数据，我们进行了系统回顾和荟萃分析，以确定与术后房颤风险增加患者相关的术前临床风险因素。对PubMed、MEDLINE和EMBASE数据库进行了系统检索。本荟萃分析纳入了2001年至2017年5月发表的24项报告了有关POAF风险因素的单变量分析结果的研究，受试者总数为36，834例。18项研究在美国和欧洲进行，16项研究为前瞻性队列研究。POAF和非POAF组之间的年龄（0.55：0.47 - 0.63）、左心房直径（0.45：0.15 - 0.75）和左心室射血分数（0.30：0.14 - 0.47）的标准化平均差（SMD：95% CI）存在显著差异[报告为（SMD：95% CI）]。合并优势比[（报告为（OR：95% CI））证明心力衰竭（1.56：1.31 ~ 1.96）、慢性阻塞性肺疾病（1.36：1.13 ~ 1.64）、高血压（1.29：1.12 ~ 1.48）和心肌梗死（1.18：1.05 ~ 1.34）是POAF发生率的显著预测因素，而糖尿病的预测意义不大（1.06：1.00 ~ 1.13）。目前的分析表明，无论纳入的研究是前瞻性还是回顾性数据集，年龄较大和心力衰竭病史始终是POAF的重要危险因素。
Post-operative atrial fibrillation (POAF) is a common arrhythmia following cardiac surgery and is associated with increased healthcare costs, complications, and mortality. The etiology of POAF is incompletely understood and its prediction remains suboptimal. Using data from published studies, we performed a systemic review and meta-analysis to identify preoperative clinical risk factors associated with patients at increased risk for POAF. A systematic search of PubMed, MEDLINE, and EMBASE databases was performed. Twenty-four studies that reported univariate analysis results regarding POAF risk factors, published from 2001 to May 2017, were included in this meta-analysis with a total number of 36,834 subjects. Eighteen studies were carried out in the USA and Europe and 16 studies were prospective cohort studies. The standardized mean difference (SMD) between POAF and Non-POAF groups was significantly different [reported as (SMD: 95% CI)] for age (0.55: 0.47 to 0.63), left atrial diameter (0.45: 0.15 to 0.75), and left ventricular ejection fraction (0.30: 0.14 to 0.47). The pooled odds ratios [(reported as (OR: 95% CI)) demonstrated that heart failure (1.56: 1.31 to 1.96), chronic obstructive pulmonary disease (1.36: 1.13 to 1.64), hypertension (1.29: 1.12 to 1.48), and myocardial infarction (1.18: 1.05 to 1.34) were significant predictors of POAF incidence, while diabetes was marginally significant (1.06: 1.00 to 1.13). The present analysis suggested that older age and history of heart failure were significant risk factors for POAF consistently whether the included studies were prospective or retrospective data sets.
登录
查看更多内容
影响因子：
1.1
作者：
Gode S;Aksu T;Demirel A;Sunbul M;Gul M;Bakır I;Yeniterzi M
通讯作者：
Yeniterzi M
影响因子：
4.9
作者：
Alexandre, Joachim;Saloux, Eric;Milliez, Paul
通讯作者：
Milliez, Paul
DOI：
10.1053/j.jvca.2015.01.023
发表时间：
2015-10-01
影响因子：
2.8
作者：
Bouchot, Olivier;Guenancia, Charles;Laurent, Gabriel
通讯作者：
Laurent, Gabriel
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
DOI：
10.1007/s10840-008-9358-3
发表时间：
2009-06
影响因子：
1.8
作者：
Dun, Wen;Boyden, Penelope A.
通讯作者：
Boyden, Penelope A.