Predictors of atrial dysrhythmias for patients undergoing coronary artery bypass grafting.

BACKGROUND: Coronary artery bypass grafting is a commonly used and effective procedure for treating coronary artery disease. Atrial dysrhythmias are common after this surgery, but definitive characteristics that predict the development of such dysrhythmias postoperatively have not been determined.

OBJECTIVES: To determine demographic, preoperative, intraoperative, and postoperative factors that are predictive of atrial dysrhythmias that occur after coronary artery bypass grafting.

METHODS: A descriptive design was used to study a convenience sample (N = 162) of adult patients undergoing coronary artery bypass grafting. Data were collected via prospective chart review. Patients were grouped according to whether or not atrial dysrhythmias developed after coronary artery bypass grafting. Univariate analyses followed by multivariate analyses were conducted by using forward stepwise logistic regression to determine variables that are predictive of atrial dysrhythmias after coronary artery bypass grafting.

RESULTS: Postoperative atrial dysrhythmias developed in 52 patients (32.1%). Univariate predictors of postoperative atrial dysrhythmias included older age (P < .001) and presence of right coronary artery disease (P = .004). Multivariate predictors of postoperative atrial dysrhythmias included age (odds ratio by decade = 1.93, 95% CI = 1.86-2.00, P < .001) and right coronary artery disease (odds ratio = 2.67, 95% CI = 1.14-6.23, P = .02). Hospital stay was significantly longer (P = .003) in patients who had postoperative atrial dysrhythmias than in patients who did have these dysrhythmias.

CONCLUSIONS: Age and right coronary artery disease can be used to predict which patients will be at increased risk for atrial dysrhythmias after coronary artery bypass grafting.