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Postoperative atrial fibrillation impacts on costs and one-year clinical outcomes: the Veterans Affairs Randomized On/Off Bypass Trial.

Publication ,  Journal Article
Almassi, GH; Wagner, TH; Carr, B; Hattler, B; Collins, JF; Quin, JA; Ebrahimi, R; Grover, FL; Bishawi, M; Shroyer, ALW ...
Published in: The Annals of thoracic surgery
January 2015

New-onset postoperative atrial fibrillation (POAF) after coronary artery bypass graft surgery (CABG) is associated with worse in-hospital morbidity and mortality, extended hospital stays, and higher costs. Beyond the initial hospital discharge, the cost and outcomes of POAF have not been well studied.For CABG patients with and without new-onset POAF, a retrospective propensity-matched, multivariable regression analysis was performed to compare 1-year outcomes (including health-related quality of life [HRQoL] scores and mortality rates) and costs (standardized to 2010 dollars). Regression models controlled for site and patient factors, with propensity matching used to adjust for differences in POAF versus no-POAF patients' risk profiles.Using the existing CABG trial database, 2,096 patient records were analyzed, including POAF patients (n = 549) versus no-POAF patients (n = 1,547). For the index CABG hospitalization, POAF patients had longer postoperative length of stay (+3.9 days) and higher discharge costs (+$13,993) than no-POAF patients. At 1 year, POAF patients had more than twice the adjusted odds of dying (p < 0.01), with higher 1-year total cumulative costs. This 1-year cost difference (+$15,593) was largely attributable to hospital-based costs during the index surgery hospitalization. There was no difference in 1-year HRQoL scores (or HRQoL score changes) between POAF patients and no-POAF patients.Compared with no-POAF patients, POAF patients had higher discharge and 1-year costs along with higher 1-year mortality rates, but no differences were observed in 1-year HRQoL scores. Additional research appears warranted to improve the longer-term survival rates for POAF CABG patients, targeting future POAF-specific postdischarge interventions.

Duke Scholars

Published In

The Annals of thoracic surgery

DOI

EISSN

1552-6259

ISSN

0003-4975

Publication Date

January 2015

Volume

99

Issue

1

Start / End Page

109 / 114

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
  • Male
  • Humans
  • Hospital Costs
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Almassi, G. H., Wagner, T. H., Carr, B., Hattler, B., Collins, J. F., Quin, J. A., … VA #517 Randomized On/Off Bypass (ROOBY) Study Group, . (2015). Postoperative atrial fibrillation impacts on costs and one-year clinical outcomes: the Veterans Affairs Randomized On/Off Bypass Trial. The Annals of Thoracic Surgery, 99(1), 109–114. https://doi.org/10.1016/j.athoracsur.2014.07.035
Almassi, G Hossein, Todd H. Wagner, Brendan Carr, Brack Hattler, Joseph F. Collins, Jacquelyn A. Quin, Ramin Ebrahimi, et al. “Postoperative atrial fibrillation impacts on costs and one-year clinical outcomes: the Veterans Affairs Randomized On/Off Bypass Trial.The Annals of Thoracic Surgery 99, no. 1 (January 2015): 109–14. https://doi.org/10.1016/j.athoracsur.2014.07.035.
Almassi GH, Wagner TH, Carr B, Hattler B, Collins JF, Quin JA, et al. Postoperative atrial fibrillation impacts on costs and one-year clinical outcomes: the Veterans Affairs Randomized On/Off Bypass Trial. The Annals of thoracic surgery. 2015 Jan;99(1):109–14.
Almassi, G. Hossein, et al. “Postoperative atrial fibrillation impacts on costs and one-year clinical outcomes: the Veterans Affairs Randomized On/Off Bypass Trial.The Annals of Thoracic Surgery, vol. 99, no. 1, Jan. 2015, pp. 109–14. Epmc, doi:10.1016/j.athoracsur.2014.07.035.
Almassi GH, Wagner TH, Carr B, Hattler B, Collins JF, Quin JA, Ebrahimi R, Grover FL, Bishawi M, Shroyer ALW, VA #517 Randomized On/Off Bypass (ROOBY) Study Group. Postoperative atrial fibrillation impacts on costs and one-year clinical outcomes: the Veterans Affairs Randomized On/Off Bypass Trial. The Annals of thoracic surgery. 2015 Jan;99(1):109–114.
Journal cover image

Published In

The Annals of thoracic surgery

DOI

EISSN

1552-6259

ISSN

0003-4975

Publication Date

January 2015

Volume

99

Issue

1

Start / End Page

109 / 114

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
  • Male
  • Humans
  • Hospital Costs