Postcardiac surgery complications: Association of acute renal dysfunction and atrial fibrillation

Maher J. Albahrani, Madhav Swaminathan, Barbara Phillips-Bute, Peter K. Smith, Mark F. Newman, Joseph P. Mathew, Mark Stafford-Smith

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of atrial fibrillation and renal dysfunction has not been performed. Therefore, we tested the hypothesis that patients with new-onset atrial fibrillation complicating coronary bypass surgery have a greater postoperative creatinine increase. Data were obtained for 453 elective coronary bypass surgery patients with no history of atrial fibrillation. Multivariate regression analyses of factors associated with peak fractional change in creatinine demonstrated a two-way interaction between age and atrial fibrillation (variable estimate, -1.1; P = 0.002). Similar results were obtained in a secondary multivariate model analyzing factors associated with peak postoperative creatinine (variable estimate, -0.01; P = 0.04). We confirmed our hypothesis that patients with new-onset atrial fibrillation are more likely to have acute renal dysfunction after cardiac surgery. The association of atrial fibrillation and creatinine increase diminishes with advancing age. These data are consistent with a common pathophysiology that contributes in an age-dependent fashion to the etiology of both acute renal dysfunction and atrial fibrillation after coronary bypass surgery.

Original languageEnglish
Pages (from-to)637-643
Number of pages7
JournalAnesthesia and Analgesia
Volume96
Issue number3
DOIs
StatePublished - Mar 1 2003

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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