Impact of postoperative atrial fibrillation (POAF) on outcomes after coronary artery bypass grafting: A meta-analysis of unique 247,270 patients from 50 studies
Bibliographic record
Abstract
Postoperative atrial fibrillation (POAF) can occur in up to 53.1 % of patients undergoing cardiac surgery. This serious condition has been associated with increased risk of morbidity and mortality during the initial weeks after the procedure. In this updated meta-analysis, we aim to study the impact of POAF on outcomes in patients undergoing CABG surgery. We searched PubMed, Scopus, Cochrane Library, and WOS from inception till April 15, 2024. The pooled effect sizes were mean difference (MD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes and a 95 % confidence interval (CI). A total of 247,270 patients from 50 studies were included. Mean age ranged between 56.5 and 76 years and mean follow-up time duration ranged from six months to 15 years. In-hospital, 30-days, and long-term mortality were significantly higher in patients with POAF compared to patients without POAF with (OR: 2.37; 95 % CI: 1.45–3.87; P = 0.0033), (OR: 2.33; 95 % CI: 1.74–3.13; P < 0.01), and (OR: 2.15; 95 % CI: 1.8–2.54; P < 0.01respectively. In terms of stroke, both short- and long-term strokes were significantly higher in patients with POAF with (OR: 2.54; 95 % CI: 2.05–3.15; P < 0.01) and (OR: 1.92; 95 % CI: 1.37–2.68; P < 0.0007), respectively. Although POAF has significant longer hospital and intensive care unit stay and higher risk for post-operative renal failure and myocardial infarction, there was no significant difference in revascularization and reintubation rates in patients with POAF with (OR: 1.11; 95 % CI: 0.48–2.54; P = 0.656) and (OR: 2.72; 95 % CI: 0.86–8.67; P = 0.0742), respectively. The need for intra-aortic balloon pump was higher in POAF group with (OR: 1.84; 95 % CI: 1.42–2.37; P < 0.01) as well as the risk of developing heart failure with OR: 1.8; 95 % CI: 1.43–2.26; P = 0.0012. Our findings suggest that POAF group may be associated with higher short-term mortality, long-term mortality, and length of hospital and ICU stay in patients undergoing CABG. Furthermore, there was a higher association between POAF and some postoperative complications such as stroke, acute renal failure, acute heart failure, and pneumonia. However, POAF did not seem to significantly affect rates of acute MI and reintubation.
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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 | 0.011 | 0.021 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.049 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".