Resource utilization related to atrial fibrillation after coronary artery bypass grafting.
BACKGROUND
Studies of resource utilization by patients with new-onset atrialfibrillation after coronary artery bypass grafting have addressed only length of stay and bed charges.


OBJECTIVE
To compare resource utilization between patients with new-onset atrial fibrillation and patients without atrialfibrillation after isolated coronary artery bypass grafting.


METHODS
Retrospective review of clinical and administrative electronic databases for 720 subjects who underwent isolated coronary artery bypass grafting with cardiopulmonary bypass in 25 months at one medical center The prevalence of atrial fibrillation was determined, and resource utilization in various hospital cost centers was compared between subjects with and without atrialfibrillation.


RESULTS
The prevalence of new-onset atrial fibrillation was 33.1%. Compared with subjects without atrialfibrillation, subjects with atrialfibrillation had a longer stay (5.8 +/- 2.4 vs. 4.4+/-1.2 days, P<.001), more days receiving mechanical ventilation (P =.002) and oxygen therapy (P<.001), and higher rates of readmission to the intensive care unit (4.6% vs. 0.2%, P<.001). Subjects with atrial fibrillation also had more laboratory tests (P<.001) and more days receiving cardiac drugs, heparin, diuretics, and electrolytes. Subjects with atrialfibrillation had higher total postoperative charges ($57261 +/- $17101 vs. $50905 +/- $10062, P = .001), a mean difference of $6356. The mean differences were greatest for bed charges ($1642), laboratory charges ($1215), pharmacy ($989), and respiratory care ($582).


CONCLUSIONS
The economic impact of atrialfibrillation after coronary artery bypass grafting has been underestimated.
Hravnak
Marilyn
M
Department of Acute/Tertiary Care, School of Nursing, University of Pittsburgh, PA, USA.
Hoffman
Leslie A
LA
Saul
Melissa I
MI
Zullo
Thomas G
TG
Whitman
Gayle R
GR
D000368:Aged; D001281:Atrial Fibrillation / Q000191:economics* / Q000628:therapy*; D001026:Coronary Artery Bypass / Q000191:economics*; D005260:Female; D006295:Health Resources; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies