Internal Validation of a Risk Score for Prediction of Postoperative Atrial Fibrillation after Cardiac Surgery
Int. j. cardiovasc. sci. (Impr.)
;
33(2): 158-166, Mar.-Apr. 2020. tab, graf
Article
in English
| LILACS
| ID: biblio-1090657
ABSTRACT
Abstract 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 ofoutcome:
age (≥ 70 years), mitral valve disease, the non-use 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 x(2) = 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.
Full text:
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Index:
LILACS (Americas)
Main subject:
Postoperative Complications
/
Atrial Fibrillation
/
Heart Valves
/
Myocardial Revascularization
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Journal subject:
Cardiology
Year:
2020
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Universitária de Cardiologia/BR
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