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
Artigo
em Inglês
| LILACS
| ID: biblio-1090657
Biblioteca responsável:
BR1.1
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.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Complicações Pós-Operatórias
/
Fibrilação Atrial
/
Valvas Cardíacas
/
Revascularização Miocárdica
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Int. j. cardiovasc. sci. (Impr.)
Assunto da revista:
Cardiologia
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Fundação Universitária de Cardiologia/BR