Lucrecia María Burgos1, Leonardo Seoane2, Josefina Belén Parodi3, Juan Espinoza2, Victoria Galizia Brito3, Mariano Benzadón3, Daniel Navia2. 1. Department of Clinical Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. Electronic address: lburgos@icba.com.ar. 2. Department of Cardiac Surgery, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. 3. Department of Clinical Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina.
Abstract
OBJECTIVE: To compare the performance of the CHADS VASc, POAF, and HATCH scoring systems to predict new-onset atrial fibrillation after cardiac surgery. METHODS: We conducted a single-center cohort study, performing a retrospective analysis of prospectively collected data. The study included consecutive patients undergoing cardiac surgery between January 2010 and December 2016. The primary outcome was the development of new-onset postoperative atrial fibrillation during hospitalization. RESULTS: A total of 3113 patients underwent cardiac surgery during the study period: coronary artery bypass graft surgery (45%), valve replacement (24%), combined procedure (revascularization-valve surgery) (15%), and other procedures (16%). Twenty-one percent (n = 654) presented postoperative atrial fibrillation. Median scores in patients with postoperative atrial fibrillation were significantly higher (P < .001). The CHAD2DS2-VASc score demonstrated greater discriminative ability to predict the event (C-statistic, 0.77; 95% confidence interval [CI], 0.75-0.79) versus the POAF score and the HATCH score (C-statistic, 0.71; 95% CI, 0.69-0.73 and C-statistic, 0.70; 95% CI, 0.67-0.72, respectively). All 3 scores presented good calibration according to the Hosmer-Lemeshow test univariate and multivariable analysis demonstrated that the 3 scores were independent predictors of postoperative atrial fibrillation: CHA2DS2-VASc score odds ratio 1.87 (95% CI, 1.64-2.13), POAF score odds ratio 1.18 (95% CI, 1.01-1.36), and HATCH score odds ratio 1.62 (95% CI, 1.37-1.92). CONCLUSIONS: The POAF, CHA2DS2-VASc, and HATCH scoring systems showed good discrimination and calibration to predict postoperative atrial fibrillation in patients undergoing cardiac surgery. Among them, the CHA2DS2-Vasc score presented the best discriminative ability for postoperative atrial fibrillation and has the advantage of being easy to calculate.
OBJECTIVE: To compare the performance of the CHADS VASc, POAF, and HATCH scoring systems to predict new-onset atrial fibrillation after cardiac surgery. METHODS: We conducted a single-center cohort study, performing a retrospective analysis of prospectively collected data. The study included consecutive patients undergoing cardiac surgery between January 2010 and December 2016. The primary outcome was the development of new-onset postoperative atrial fibrillation during hospitalization. RESULTS: A total of 3113 patients underwent cardiac surgery during the study period: coronary artery bypass graft surgery (45%), valve replacement (24%), combined procedure (revascularization-valve surgery) (15%), and other procedures (16%). Twenty-one percent (n = 654) presented postoperative atrial fibrillation. Median scores in patients with postoperative atrial fibrillation were significantly higher (P < .001). The CHAD2DS2-VASc score demonstrated greater discriminative ability to predict the event (C-statistic, 0.77; 95% confidence interval [CI], 0.75-0.79) versus the POAF score and the HATCH score (C-statistic, 0.71; 95% CI, 0.69-0.73 and C-statistic, 0.70; 95% CI, 0.67-0.72, respectively). All 3 scores presented good calibration according to the Hosmer-Lemeshow test univariate and multivariable analysis demonstrated that the 3 scores were independent predictors of postoperative atrial fibrillation: CHA2DS2-VASc score odds ratio 1.87 (95% CI, 1.64-2.13), POAF score odds ratio 1.18 (95% CI, 1.01-1.36), and HATCH score odds ratio 1.62 (95% CI, 1.37-1.92). CONCLUSIONS: The POAF, CHA2DS2-VASc, and HATCH scoring systems showed good discrimination and calibration to predict postoperative atrial fibrillation in patients undergoing cardiac surgery. Among them, the CHA2DS2-Vasc score presented the best discriminative ability for postoperative atrial fibrillation and has the advantage of being easy to calculate.
Authors: Lucrecia María Burgos; Andreina Gil Ramírez; Victoria Galizia Brito; Leonardo Seoane; Juan Francisco Furmento; Juan Espinoza; Mirta Diez; Mariano Benzadon; Daniel Navia Journal: J Atr Fibrillation Date: 2020-08-31
Authors: Lucrecia M Burgos; Andreína Gil Ramírez; Leonardo Seoane; Juan F Furmento; Juan P Costabel; Mirta Diez; Daniel Navia Journal: Ann Card Anaesth Date: 2021 Oct-Dec