Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries

Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries

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.

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Main Authors: Silva,Natália Aline da, Butcher,Rita de Cássia Gengo e Silva
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Cardiologia 2019
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600585
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spelling oai:scielo:S2359-564720190006005852019-11-26Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac SurgeriesSilva,Natália Aline daButcher,Rita de Cássia Gengo e Silva Atrial Fibrillation Arrhythmias, Cardiac/complications Postoperative Complications Cardiac Surgical Procedures 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.info:eu-repo/semantics/openAccessSociedade Brasileira de CardiologiaInternational Journal of Cardiovascular Sciences v.32 n.6 20192019-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600585en10.5935/2359-4802.20190042
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countrycode BR
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databasecode rev-scielo-br
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region America del Sur
libraryname SciELO
language English
format Digital
author Silva,Natália Aline da
Butcher,Rita de Cássia Gengo e Silva
spellingShingle Silva,Natália Aline da
Butcher,Rita de Cássia Gengo e Silva
Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
author_facet Silva,Natália Aline da
Butcher,Rita de Cássia Gengo e Silva
author_sort Silva,Natália Aline da
title Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
title_short Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
title_full Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
title_fullStr Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
title_full_unstemmed Left Atrial Size Contribution to the Predictive Capacity of Two Scores for Atrial Fibrillation in the Postoperative Period of Cardiac Surgeries
title_sort left atrial size contribution to the predictive capacity of two scores for atrial fibrillation in the postoperative period of cardiac surgeries
description 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.
publisher Sociedade Brasileira de Cardiologia
publishDate 2019
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600585
work_keys_str_mv AT silvanataliaalineda leftatrialsizecontributiontothepredictivecapacityoftwoscoresforatrialfibrillationinthepostoperativeperiodofcardiacsurgeries
AT butcherritadecassiagengoesilva leftatrialsizecontributiontothepredictivecapacityoftwoscoresforatrialfibrillationinthepostoperativeperiodofcardiacsurgeries
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