Prediktori postoperativne fibrilacije atrija nakon izolirane zamjene aortne valvule

master's thesis

• Title (english): Predictor of postoperative atrial fibrillation following isolated aortic valve replacement
• Author: Nora Knez
• Mentor: Hrvoje Gašparović (mentor)
• Committee member: Tomislav Kopjar (predsjednik povjerenstva)
• Committee member: Anko Antabak (član povjerenstva)
• Committee member: Hrvoje Gašparović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Novonastala postoperativna fibrilacija atrija (POAF) je česta komplikacija nakon kardiokirurških operacija, sa stopom incidencije 20 - 60%. Povezana je s povećanim perioperativnom morbiditetom, mortalitetom i troškovima liječenja. Osim toga, neovisni je prediktor ranih i dugoročnih kardiovaskularnih komplikacija. Primarni cilj ove studije bio je konstruiranje prediktivnog modela za procjenu razvoja POAF nakon izolirane zamjene aortalne valvule (AVR) na temelju kliničkih i proceduralnih parametara. Sekunadrni cilj bio je utvrđivanje incidencije POAF. Provedena je retrospektivna kohortna studija kojom su uključeni svi uzastopni bolesnici podvrgnuti izoliranoj AVR od siječnja 2010. do prosinca 2022. na Klinici za kardijalnu kirurgiju Kliničkog bolničkog centra Zagreb. Studijom je utvrđena stopa prevalencije POAF od 26.8%. Konačni model multivarijantne analize identificirao je dob (p<0.001), dužinu boravka u jedinici intenzivnog liječenja (p=0.001) i mehaničku ventilaciju (p=0.023) kao značajne čimbenike rizika za razvoj POAF nakon izolirane AVR. Jednostavni prediktivni model razvijen u ovoj studiji vrijedan je alat za identificiranje bolesnika s visokim rizikom od razvoja POAF nakon izolirane AVR. Implementacija ciljanih intervencija na temelju procjene rizika mogla bi dovesti do boljih ishoda i smanjenja troškova zdravstvene zaštite.

Abstract (english)

New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, with an incidence rate of 20-60%. It is associated with increased perioperative morbidity, mortality, and healthcare costs. In addition, it is an independent predictor of early and long-term cardiovascular complications. The primary objective of this study was to construct a predictive model for assessing the development of POAF after isolated aortic valve replacement (AVR) based on clinical and procedural parameters. The secondary objective was to determine the incidence of POAF. A retrospective cohort study was conducted, including all consecutive patients undergoing isolated AVR from January 2010 to December 2022 at the Clinic for Cardiac Surgery of the University Hospital Center Zagreb. The study found a prevalence rate of POAF of 26.8%. The final model of multivariate analysis identified age (p<0.001), length of stay in the intensive care unit (p=0.001), and mechanical ventilation (p=0.023) as significant risk factors for the development of POAF after isolated AVR. The simple predictive model developed in this study is a valuable tool for identifying patients at high risk of developing POAF after isolated AVR. Implementation of targeted interventions based on risk assessment could lead to better outcomes and reduced healthcare costs.

• Keywords: postoperativna fibrilacija atrija; zamjena aortalne valvule; multivarijantna analiza
• Keywords (english): postoperative atrial fibrillation; aortic valve replacement; multivariant analysis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:756742
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-25 10:39:43