Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
Int. j. cardiovasc. sci. (Impr.)
;
32(6): 585-593, Nov.-Dec. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1056379
ABSTRACT
Abstract Background:
Postoperative atrial fibrillation (POAF) is a common complication associated with undesirable outcomes; hence, the provision of appropriate tools is important to help identify patients at risk.Objectives:
To evaluate the predictive capacity of the CHADS2 and CHA2DS2-VASc scores, alone and combined with left atrial (LA) size, for the onset of POAF in patients undergoing coronary artery bypass grafting and/or valvular surgery.Methods:
We performed a retrospective cohort study on 144 patients. A decision tree was used to identify the cut-off values of the CHADS2 and CHA2DS2-VASc scores and LA size in order to calculate sensitivity, specificity, predictive-value positive (PVP), and predictive-value negative (PVN), in addition to regression models. The receiver operating characteristic (ROC) curve was used to estimate the accuracy of the models. The level of significance adopted was 5%.Results:
Patients who developed POAF were older (p = 0.050), had reduced left ventricular ejection fraction (p = 0.045), longer hospital length of stay (p = 0,018), but their mean CHADS2 (p = 0.077) and CHA2DS2-VASc (p = 0.109) scores were similar to those of patients with no arrhythmia. LA size improved the predictive capacity of the CHADS2 score, in terms of specificity and PVP, and of the CHA2DS2-VASc score, in terms of sensitivity and PVN. However, the CHADS2 (OR = 1.198; CI95% = 0.859-1.156) and CHA2DS2-VASc (OR = 1.047; CI95% = 0.784-1.401) scores were not predictors of POAF, either alone or in combination with LA size (OR = 1.163; CI95% = 0.829-1.648 and OR = 1.065; CI95% = 0.795-1.433).Conclusion:
The CHADS2 and CHA2DS2-VASc scores alone or in combination with LA size did not show good predictive capacity for POAF.
Full text:
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Index:
LILACS (Americas)
Main subject:
Postoperative Complications
/
Atrial Fibrillation
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Journal subject:
Cardiology
Year:
2019
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Escola de enfermagem da Universidade de São Paulo/BR
/
Faculdade de Medicina da Universidade de São Paulo/BR
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