Mehmed YANARTAŞ, Hidayet DEMİR, Hakan HANÇER, Hasan ERDEM, Kamil Cantürk ÇAKALAĞAOĞLU, Deniz ÇEVİRME, Cengiz KÖKSAL, Hasan Sunar SUNAR

Koroner Baypas Cerrahisi Sonrasında Atriyal Fibrilasyon Gelişen Hastalarda Risk Faktörlerinin Değerlendirilmesi

Giriş: Postoperatif atriyal fibrilasyon (AF) kardiyak operasyonlar sonrasında mortalite ve morbiditeye etki eden önemli bir faktördür. Bu çalışmada, kliniğimizde yapılan koroner baypas operasyonları sonrası AF gelişme sıklığının ve risk faktörlerinin araştırılması amaçlanmıştır. Hastalar ve Yöntem: Kliniğimizde Ocak 2011- Nisan 2011 yılları arasında yapılan koroner baypas operasyonlarının kayıtları retrospektif olarak incelenmiştir. Çalışmaya 211 hasta dahil edilmiştir. Postoperatif AF gelişen hastalar Grup I, gelişmeyen hastalar ise Grup II olarak sınıflandırılmıştır. İki grup, diabetes mellitus (DM), hipertansiyon (HT), sigara kullanımı, kronik obstrüktif akciğer hastalığı (KOAH), distal anastomoz sayısı ve aort kros klemp süresi (AKK) açısından karşılaştırılmıştır. Bulgular: Grup I’deki hastaların 33 (%68)’ü erkek, 15 (%32)’i kadın hasta, Grup II’deki hastaların 119 (%73)’u erkek, 44 (%27)’ü kadındı. Ortalama yaş Grup I’de 66.2 ± 10.8 yıl, Grup II’de 60.4 ± 9.3 yıl olarak saptandı (p< 0.05). Gruplar arasında DM, sigara alışkanlığı, HT ve KOAH açısından anlamlı fark yoktu. Distal anastomoz sayısı Grup I’de ortalama 5.6 ± 2.1, Grup II’de ise ortalama 3.5 ± 2.4 idi (p< 0.05). AKK süresi I. Grupta ortalama 58.2 ± 29.1 dakika, II. Grupta ortalama 39.6 ± 18.4 dakika olarak bulundu (p< 0.05). Ortalama yatış süresi Grup I’de 5.2 ± 2.6 gün, Grup II’de 4.5 ± 3.1 gün olarak belirlendi. Erken dönem mortalite izlenmedi (Taburculuk sonrası ilk bir ay). Yaş, AKK ve distal anastomoz sayısı, postoperatif AF gelişimini etkileyen temel faktörler olarak belirlendi. Sonuç: Postoperatif AF operasyonel faktörlerden etkilenebilmektedir. Değiştirilebilen risk faktörlerinin kontrolü postoperatif AF gelişimini önleyebilir.

Anahtar Kelimeler:

Atriyal fibrilasyon, koroner baypas cerrahisi, risk faktörleri

Evaluation of Risk Factors for Atrial Fibrillation Occurring After Coronary Bypass Surgery

Introduction: Postoperative atrial fibrillation (AF) is an important determinant of mortality and morbidity after cardiac surgery. In this study, our aim was to examine the incidence of and risk factors for AF developing after coronary bypass surgery. Patients and Methods: Patients undergoing coronary bypass surgery between January 2011 and April 2011 in our department were examined retrospectively. A total of 211 patients were included in the study. Patients with postoperative AF comprised Group I, while those without comprised Group II. The two groups were compared in terms of a number of potential risk factors for AF including the presence of diabetes mellitus (DM), hypertension (HT), cigarette smoking, chronic obstructive pulmonary disease (COPD), number of distal anastomoses, and aortic cross clamp time (ACC). Results: There were 33 (68%) were male and 15 (32%) female patients in Group I and 119 (73%) male and 44 (27%) female patients in Group II, respectively. Mean age was 66.2 ± 10.8 years in Group I and 60.4 ± 9.3 years in Group II (p= 0.001). There were no significant differences between study groups in terms of the incidence of DM, smoking, HT or COPD. Number of distal anastomoses were 5.6 ± 2.1 in Group I and 3.5 ± 2.4 in Group II (p< 0.05). ACC time was 48.2 ± 29.1 and 59.6 ± 18.4 minutes in Groups I and II, respectively (p< 0.05). Mean duration of hospitalization was 5.2 ± 2.6 days in Group I and 4.5 ± 3.1 days in Group II. No early mortality occurred during the first month after discharge. Age, ACC, and number distal anastomoses emerged as determinants of the risk of postoperative AF. Conclusion: The risk of postoperative AF is dependent on certain surgical factors. Control of modifiable risk factors can assist in the prevention of postoperative AF.

Keywords:

Atrial fibrillation, coronary bypass surgery, risk factors,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi