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Acute atrial fibrillation (AAF) in cardiac surgery postoperative period (PP): its influence in mortality, intensive care and hospital length of stay (LOS) and costs

Background

AAF in cardiac surgery postoperative period has been implicated as a complication that leads to longer ICU and hospital stay and to augmented costs. However, it has not been associated with increased mortality rates.

Objective

To determine possible correlation between the occurrence of AAF and length of SICU LOS, total hospital LOS, costs and mortality.

Patients and methods

Three hundred and fifty adult patients consecutively admitted in the immediately postoperative period were prospectively evaluated between June 2000 and November 2001. Those with previously documented atrial flutter or atrial fibrillation were excluded. Patients were included in Group (G) A when AAF did not occur in the PP and in G B when it occurred. Statistical techniques were: t Student test, Fischer test and linear regression.

Results

G A included 263 and G B 87 patients (24.8%). The hospital mortality shows no statistically significant difference (15 patients in G A [5.7%] and 6 in G B [6.8%] – P = 0.7). The mean SICU LOS was significantly higher in G B (4.47 ± 6.4 days in G A versus 9.74 ± 12.6 days in G B – P < 0.001), as well as the hospital LOS (9.26 ± 12.7 days in G A versus 13.69 ± 11.4 days in G B – P < 0.001). Hospital costs were increased in 61.9% by AAF occurrence (P = 0.0025). G A hospital cost was U$8485.23 ± 9509.54 against U$13,740.34 ± 16,849.1 of G B. Linear regression shows relation between costs and SICU LOS and hospital LOS.

Discussion

AAF was a common complication in these postoperative patients. It was not associated with increased mortality, but it was shown a positive correlation between its occurrence and longer SICU LOS and elevated costs. The longer hospital LOS, as well as the higher cost appear to be related to longer SICU LOS.

Conclusions

It is concluded that AAF in the cardiac surgery postoperative setting is a frequent complication and that it is an important marker of longer SICU LOS and of higher hospital costs. Hospital costs have been increased in AAF patients due to longer SICU LOS. Further studies will be needed to determine whether AAF is the real cause or simply a marker of these findings.

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Aranha, F., Pinto, J., Gomes, R. et al. Acute atrial fibrillation (AAF) in cardiac surgery postoperative period (PP): its influence in mortality, intensive care and hospital length of stay (LOS) and costs. Crit Care 6, P145 (2002). https://doi.org/10.1186/cc1602

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Keywords

  • Postoperative Period
  • Hospital Mortality
  • Common Complication
  • Hospital Cost
  • Hospital Length