Abstract 17968: Concomitant Atrial Fibrillation Surgery Does Not Increase the Risk for Mortality and Morbidity After Coronary Artery Bypass Grafting
Bibliographic record
Abstract
Introduction: As a result of the increasing age of patients requiring myocardial revascularization for ischemic heart disease, preexisting atrial fibrillation (AF) is increasing among the patients who undergo coronary artery bypass grafting (CABG). However the impact of concomitant AF surgery on the early outcomes in patients after CABG remains unknown. The aim of this study was to assess the influences of concomitant AF surgery on the risk for mortality and morbidity after CABG. Methods: By using the Japan Adult Cardiovascular Surgery Database (JACVSD), the outcomes of patients with preoperative AF who underwent CABG were analyzed and compared between patients who underwent concomitant AF surgery with CABG and isolated CABG without AF surgery. A logistic regression model was used to assess whether concomitant AF surgery increased risk in CABG cohort and propensity-matched analysis was also performed based on preoperative variables. Results: From January 2004 to December 2008, a total of 19,495 patients underwent first-time CABG and 905 (4.6%) patients of them had preoperative AF. Of these, 253 (28.0%) patients had a concomitant AF surgery (AF surgery group) and 652 patients underwent isolated CABG (isolated CABG group). Overall, operative mortality (2.0% in AF surgery group, 3.1% in isolated CABG group) and major morbidity (18.6% in AF surgery group, 20.9% in isolated CABG group) were similar, and concomitant AF surgery did not have a significantly higher risk of mortality (odds ratio =0.78, 95% confidence interval 0.22-2.73; p=0.70) or major morbidity (odds ratio =1.11, 95% confidence interval 0.67-1.82; p=0.69).The propensity score matching analysis identified each 144 patients in both groups and neither operative mortality (2.8% in AF surgery group, 2.1% in isolated CABG group, p=0.70) nor major morbidity (18.8% in AF surgery group, 19.4% in isolated CABG group, p=0.88) had significant deference. Conclusions: From the analysis of overall data of JACVSD, mortality and major morbidity were slightly higher in isolated CABG group and it supposed that AF correction surgery might be performed in lower risk patients. Even after propensity matching, concomitant AF surgery was performed safely without increasing the risk for mortality and morbidity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".