Abstract 12326: Postoperative Atrial Fibrillation Impacts One Year Clinical Outcomes and Costs: The VA ROOBY Trial
Purpose: Costs and clinical outcomes were compared for CABG patients with and without new onset of postoperative atrial fibrillation (POAF).
Methods: In a multi-center, randomized trial comparing off-pump vs. on-pump treatments, quality of life (QoL), mortality and costs were compared for POAF (n = 551) versus no POAF (n = 1559) patients. QoL was measured using the Veterans-specific SF-36 Physical (PCS) and Mental Component Summary (MCS) scales. Costs included VA medical care, non-VA medical care, and patient-incurred travel costs (standardized to 2010 dollars). Regression models estimated clinical outcomes and costs, while controlling for site and patient factors.
Results: At 1-year, there was no difference in PCS or MCS scores (or score changes) between POAF vs. no POAF patients. Adjusted post-operative length of stay was 3.9 days longer and costs were 22.7% higher for POAF vs. no POAF patients. At 1-year, POAF patients had over twice the adjusted odds of dying and $15,772 higher total cumulative costs vs. no POAF patients. No POAF with treatment interaction effect was found. Stratified propensity matching confirmed these multivariable regression findings.
Conclusion: Compared to no POAF patients, POAF patients had higher 1-year costs and mortality rates but no 1-year PCS or MCS score differences found.
Additional research is needed to improve the future quality and efficiency of POAF patient care.
- © 2013 by American Heart Association, Inc.