1424: IMPACT OF A STANDARDIZED POSTOPERATIVE ATRIAL FIBRILLATION PROTOCOL ON ISOLATED CABG PATIENTS

Introduction: Postoperative atrial fibrillation (POAF) is a common complication following isolated coronary artery bypass graft (CABG) surgery, contributing to increased hospital length of stay (LOS) and rising healthcare costs. This study evaluated whether implementing a standardized POAF protocol reduced POAF incidence, decreased LOS, and lowered healthcare expenditures compared to standard care. Methods: A retrospective analysis was conducted comparing outcomes between patients undergoing isolated CABG surgery before and after implementation of a standardized POAF protocol. Key outcomes included POAF incidence, ICU and overall LOS, readmission rates, and financial impact. Results: Implementation of the POAF protocol led to a statistically significant reduction in new-onset atrial fibrillation from 30% to 10% (p< 0.05) and a clinically significant reduction in readmission rates from 10% to 2%. ICU LOS decreased from 6.6 to 3.8 days (p< 0.002), resulting in $8,400 savings per patient. Overall LOS was reduced from 11 days to 8.9 days (p=0.25), with associated savings of $1,575 per patient. Financial analysis demonstrated cost savings of $750 per patient day for step-down/telemetry care and $3,000 per ICU patient day. Conclusions: A standardized POAF protocol significantly reduces the incidence of new-onset atrial fibrillation, ICU LOS, and healthcare costs. While the reduction in overall LOS and readmission rates was not statistically significant, the financial implications highlight the potential value of protocolized care in improving outcomes and reducing expenditures in patients undergoing isolated CABG surgery.