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Hawkins et al. Vessel Plus 2022;6:42 Vessel Plus
DOI: 10.20517/2574-1209.2021.116

Original Article Open Access

Postoperative atrial fibrillation is associated with

increased resource utilization after cardiac surgery:
a regional analysis of the Southeastern United

States

1
4
2
3
2
Robert B. Hawkins , Raymond J. Strobel , Mark Joseph , Mohammed Quader , Nicholas R. Teman , G.
5,6
Hossein Almassi , J. Hunter Mehaffey 2
1
Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
2
Department of Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA 24106, USA.
3
Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA.
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Department of Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Department of Surgery, Zablocki VA Medical Center, Milwaukee, WI 53295, USA.
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Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Correspondence to: Asst. Prof. Robert B. Hawkins, Department of Cardiac Surgery, University of Michigan, CVC 5353, 1500 East
Medical Center Drive, Ann Arbor, MI 48109, USA. E-mail: robertbh@med.umich.edu
How to cite this article: Hawkins RB, Strobel RJ, Joseph M, Quader M, Teman NR, Almassi GH, Mehaffey JH. Postoperative atrial
fibrillation is associated with increased resource utilization after cardiac surgery: a regional analysis of the Southeastern United
States. Vessel Plus 2022;6:42. https://dx.doi.org/10.20517/2574-1209.2021.116
Received: 19 Aug 2021 First Decision: 25 Jan 2022 Revised: 7 Feb 2022 Accepted: 16 Feb 2022 Published: 4 Jul 2022
Academic Editors: Alexander D. Verin, Frank W. Sellke Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen
Abstract
Aim: Postoperative atrial fibrillation (POAF) is a known risk factor for morbidity and mortality following cardiac
surgery though contemporary resource utilization data is limited. We hypothesize that POAF increases the length
of stay, hospital cost, and discharges to facilities, though this trend may be tempering over time.

Methods: Records were extracted for all patients in a regional database who underwent coronary artery bypass
grafting, aortic valve replacement, or both (2012-2020). Patients without a history of atrial fibrillation were
stratified by POAF for univariate analysis. Patients were propensity-score matched to account for baseline,
operative, and postoperative differences.

Results: Of the 27,307 cardiac surgery patients, 23% developed POAF. Matching resulted in 5926 well-balanced
pairs of patients with and without POAF. Every metric of resource utilization was higher for patients with POAF,
including ICU length of stay (58 h vs. 49 h, P < 0.0001), postoperative length of stay (7 days vs. 5 days, P <

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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