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Internal Validation of a Risk Score for Prediction of Postoperative Atrial Fibrillation after Cardiac Surgery
Ronsoni, Rafael de March; Leiria, Tiago Luiz Luz; Pires, Leonardo Martins; Kruse, Marcelo Lapa; Pereira, Edemar; Silva, Rogerio Gomes da; Lima, Gustavo Glotz de.
  • Ronsoni, Rafael de March; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
  • Leiria, Tiago Luiz Luz; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
  • Pires, Leonardo Martins; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
  • Kruse, Marcelo Lapa; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
  • Pereira, Edemar; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
  • Silva, Rogerio Gomes da; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
  • Lima, Gustavo Glotz de; Fundação Universitária de Cardiologia. Instituto de Cardiologia. Porto Alegre. BR
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 of

outcome:

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.
Subject(s)


Full text: Available 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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Full text: Available 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