Background: Postoperative atrial fibrillation (POAF) after cardiac surgery has great clinical and economic
implications. Many attempts have been made to identify risk factors aiming at a better evaluation of prophylactic
treatment strategies.
Objective: To perform an internal validation of a risk score for POAF.
Methods: A prospective cohort of 1,054 patients who underwent myocardial revascularization and/or valve surgery was included. The risk score model was developed in 448 patients, and its performance was tested in the remaining 606 patients. Variables with a significance level of 5% in the cohort were included and subjected to a multiple logistic regression model with backward selection. Performance statistics was performed using the c-statistic, the chi-square and the Hosmer-Lemeshow (HL) goodness-of-fit, Pearson’s correlation coefficient.
Results: Four variables were considered predictors of outcome: age (≥ 70 years), mitral valve disease, the nonuse or discontinuation of beta-blockers and a positive water balance (> 1,500 mL). The ROC curve was 0.76 (95%
confidence interval [CI]: 0.72-0.79). The risk model showed a good ability according to the performance statistics –
HL test x2 = 0.93; p = 0.983 and r = 0.99 (Pearson’s coefficient). There was an increase in the frequency of POAF with the increase of the score: very low risk = 0.0%; low risk = 3.9%; intermediate risk = 10.9%; and high risk = 60.0%; p < 0.0001.
Conclusion: The predictive variables of POAF allowed us to construct a simplified risk score. This scoring system showed good accuracy and can be used in routine clinical practice. (Int J Cardiovasc Sci. 2020; 33(2):158-166)
Keywords: Atrial Fibrillation; Myocardial Revascularization; Heart Valves/surgery; Perioperative Care; Risk Score;
Prevention and Control.
Leia o artigo completo aqui: Internal Validation of a Risk Score for Prediction of Postoperative Atrial Fibrillation after Cardiac Surgery