CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 5, November/December 2023 302 AFRICA AF occurred in the first eight postoperative hours in 45 patients (24.6%); between nine and 24 hours in 52 patients (28.4%); between 25 and 72 hours in 69 patients (37.7%) and after 72hours in 17 patients (9.3%). The intra-operative and postoperative data of the patients are shown in Table 4. The length of stay in the ICU (p = 0.0001) and in hospital (p = 0.0001) were significantly different between the groups. The neurological event rate (transient ischaemic event, speech disorder, hemiplegia or hemiparesia) within the postoperative first month was significantly higher in group 1 compared to group 2 [10 patients (5.5%) vs six patients (1.0%); p = 0.001]. Mortality in the first postoperative month occurred in five patients (2.7%) in group 1 and in two patients (0.5%) in group 2, which showed a statistically highly significant difference between the groups (p = 0.008). Table 3. Early postoperative blood results and haematological parameters of patients Early postoperative blood results and haematological parameters Group 1 with AF (n = 183) Group 2 without AF (n = 607) p-value Mean ± SD Mean ± SD Haemoglobin (mg/dl) Day 1 9.02 ± 1.03 9.19 ± 1.13 0.07* Day 3 10.13 ± 1.73 10.07 ± 1.59 0.51* Day 7 10.79 ± 1.87 10.83 ± 1.91 0.48* Leukocyte counts (× 103 cells/μl) Day 1 13.11 ± 3.32 13.18 ± 3.40 0.43* Day 3 11.73±3.07 11.64±3.09 0.72* Day 7 10.13 ± 2.81 10.09 ± 2.89 0.64* CRP (mg/l) Day 1 36.59 ± 9.03 28.01 ± 5.41 0.0001* Day 3 33.89 ± 10.40 31.03 ± 7.84 0.0001* Day 7 30.46 ± 5.71 27.51 ± 4.57 0.0001* ESR (mm/h) Day 1 37.94 ± 16.08 30.89 ± 14.55 0.0001* Day 3 49.96 ± 9.71 41.36 ± 6.40 0.0001* Day 7 31.00 ± 8.21 27.28 ± 6.18 0.0001* RDW (%) Day 1 15.13 ± 1.50 13.38 ± 1.44 0.0001* Day 3 14.90 ± 1. 30 13.40 ± 1.40 0.0001 Day 7 14.44 ± 0.82 12.87 ± 1.18 0.0001* AF: atrial fibrillation, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, RDW: red blood cell distribution width. *Student’s t-test. Table 4. Intra-operative and postoperative data of the patients Characteristics Group 1 with AF (n = 183) Group 2 without AF (n = 607) p-value Mean ± SD Mean ± SD Aortic cross-clamp time (min) 52.6 ± 13.5 51.9 ± 13.2 0.56* Cardiopulmonary bypass time (min) 83.1 ± 16.4 82.2 ± 16.6 0.52* Number of anastomoses 3.35 ± 1.04 3.34 ± 0.98 0.90* Amount of drainage (ml) 349 ± 134 351 ± 128 0.88* Intubation time (h) 5.74 ± 1.51 5.59 ± 1.46 0.24* Stay in the intensive care unit (h) 29.38 ± 8.87 21.18 ± 2.37 0.0001* Total duration of hospital stay (d) 8.91 ± 2.39 5.94 ± 1.44 0.0001* Use of blood products, n (%) 69 (37.7) 202 (33.3) 0.27** Use of inotropic support, n (%) 17 (9.3) 36 (5.9) 0.11** *Student’s t-test, **Pearson’s chi-squared test. Table 5. Univariate and multivariate regression analysis of pre-operative risk factors for postoperative AF Variables Postoperative AF Unadjusted OR (95% CI) p-value R2 Adjusted OR (95% CI) p-value Haemoglobin 1.10 (0.98–1.23) 0.11 – – – Creatinine 0.98 (0.55–1.72) 0.92 – – – Urea 1.01 (0.96–1.05) 0.89 – – – HbA1c 0.96 (0.86–1.08) 0.54 – – – Left atrial diameter 1.03 (0.98–1.08) 0.28 – Ejection fraction 0.99 (0.97–1.01) 0.68 – Leucocyte counts 0.97 (0.91–1.03) 0.81 – – – Thrombocyte counts 0.94 (0.81–1.07) 0.10 – – – CRP 28.99 (17.78–42.27) 0.0001 0.42 15.35 (6.08–38.74) 0.0001 ESR 1.51 (1.40–1.62) 0.0001 0.26 1.55 (1.31–1.84) 0.0001 HDL-C 0.98 (0.95–1.01) 0.17 – – – LDL-C 0.95 (0.91–0.99) 0.21 – – – Total cholesterol 1.01 (0.98–1.04) 0.56 – – – Triglyceride 0.97 (0.86–1.08) 0.51 – – – RDW 5.24 (4.07–6.76) 0.0001 0.32 4.14 (2.35–7.31) 0.0001 AF: atrial fibrillation, HDL-C: high-density lipoprotein cholesterol, RDW: red blood cell distribution width, LDL-C: low-density lipoprotein cholesterol, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, HbA1c: glycated haemoglobin. Table 6. Univariate and multivariate regression analysis of peri-operative and postoperative risk factors for postoperative AF Variables Postoperative AF Unadjusted OR (95% CI) p-value R2 Adjusted OR (95% CI) p-value Haemoglobin Day 1 0.86 (0.74–1.01) 0.07 – – – Day 3 1.02 (0.96–1.08) 0.22 – – – Day 7 0.96 (0.91–1.01) 0.27 – – Leukocyte counts Day 1 0.98 (0.96–1.00) 0.18 – – – Day 3 0.93 (0.89–0.97) 0.72 – – – Day 7 0.99 (0.91–1.07) 0.82 – – – CRP Day 1 1.19 (1.15–1.23) 0.0001 0.24 1.31 (1.19–1.45) 0.0001 Day 3 1.04 (1.02–1.06) 0.0001 0.19 1.03 (0.95–1.12) 0.04 Day 7 1.12 (1.09–1.16) 0.0001 0.16 1.29 (1.14–1.44) 0.0001 ESR Day 1 1.03 (1.02–1.04) 0.0001 0.14 1.08 (1.01–1.15) 0.03 Day 3 1.14 (1.12–1.16) 0.0001 0.20 1.04 (1.01–1.07) 0.0001 Day 7 1.08 (1.05–1.11) 0.0001 0.15 1.09 (1.01–1.17) 0.03 RDW Day 1 2.54 (2.15–2.99) 0.0001 0.21 2.54 (1.63–3.90) 0.0001 Day 3 2.60 (2.19–3.10) 0.0001 0.19 2.65 (1.49–4.70) 0.0001 Day 7 4.61 (3.59–5.93) 0.0001 0.28 3.17 (1.74–5.77) 0.0001 Aortic cross-clamp time 1.01 (0.99–1.02) 0.56 – – – Number of anastomoses 1.01 (0.86–1.19) 0.90 – – – CPB time 1.04 (0.92–1.16) 0.52 – – – Intubation time 1.06 (0.96–1.16) 0.34 – – – Use of blood products 0.85 (0.59–1.17) 0.27 – – – Use of inotropic support 0.62 (0.34–1.25) 0.12 – – – Amount of drainage 0.97 (0.92–1.02) 0.89 – – – CPB: cardiopulmonary bypass, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, AF: atrial fibrillation, RDW: red blood cell distribution width.
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