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Development and Outcomes Assessment of an Evidence-Based Treatment Algorithm for Post-Operative Atrial Fibrillation

出版	Creighton University, 2014
URL	http://books.google.com.hk/books?id=j43csgEACAAJ&hl=&source=gbs_api

註釋Background: Practice guidelines exist for treatment of post-operative atrial fibrillation (PAOF); however, no accepted algorithm exists to guide treatment. Objective: To determine if patients treated according to an investigator-compiled practice algorithm based on the American College of Cardiology (ACC)/American Heart Association (AHA)/European Society of Cardiology (ESC) guidelines have better outcomes when compared to patients whose treatment does not follow this algorithm. Methods: A retrospective, descriptive study was conducted on a convenient sample all cardiac surgery patients from 2011 to 2013 at an urban, Midwestern Medical center (N = 140). Subjects whose treatment followed the investigator-compiled algorithm and associated outcomes were compared to those whose treatment did not. Results: Twenty-six (34.67%) of 75 subjects who met the inclusion criteria were treated according to the investigator-compiled algorithm. The majority of subjects were Caucasian males who underwent coronary artery bypass graft (CABG). Patients who were treated according to the algorithm were found to have a 3.08 times greater odds of conversion into normal sinus rhythm, than those whose treatment deterred from the algorithm (p = 0.1979). A significant difference was detected in time spent in the intensive care unit (ICU) between groups (p = 0.0451). No other significant differences in outcomes were detected. Conclusions: Few patients were treated according to the algorithm, suggesting that extensive education is needed in order to translate ACC/AHA/ESC guidelines into practice. This algorithm has the potential to facilitate treatment which is in agreement with evidence-based best practices, reduce ICU costs, and improve conversion rates.