P4738New combined risk score to predict atrial fibrillation after cardiac surgery
| العنوان: | P4738New combined risk score to predict atrial fibrillation after cardiac surgery |
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| المؤلفون: | A Gil Ramirez, R Baro Vila, F Berton, Juan F. Furmento, Juan Espinoza, Daniel Navia, M A Cracco, P R Miranda, Lucrecia María Burgos, L D Polero, L Seoane, Lorena Villalba, Mariano Benzadón |
| المصدر: | European Heart Journal. 40 |
| بيانات النشر: | Oxford University Press (OUP), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, Framingham Risk Score, business.industry, Internal medicine, medicine, Cardiology, Atrial fibrillation, Cardiology and Cardiovascular Medicine, medicine.disease, business, Cardiac surgery |
| الوصف: | Introduction Atrial fibrillation after cardiac surgery (AFCS) is associated with an increase in adverse events. The scores POAF, CHA2DS2-VASc and HATCH demonstrated a validated predictive to predict AF after CS (AFCS). Purpose To develop and validate a new risk score from the combination of the variables with highest predictive value of POAF, CHA2DS2-VASc and HATCH risk scores to predict AFCS. Methodology We conducted a single-center cohort study, performing a retrospective analysis of prospectively collected data. The study included consecutive patients undergoing CS between 2010–2016. The primary outcome was the development of new-onset AFCS during hospitalization. The variables of each score were evaluated in a multivariate regression model to determine the predictive impact. Discrimination was evaluated with area under the ROC curve (AUC-ROC) and calibration using the Hosmer-Lemeshow (HL) test. The Youden index was used to establish the best cut-off point for the score. The statistical difference between the ROC curves was evaluated with the method of DeLong et al. Results 3113 patients were included. Coronary artery bypass graft surgery 45%, valve replacement 24%, combined procedure (revascularization-valve surgery) 15%, and other procedures 16%. 21% (n=654) presented AFCS. Variables finally included in the new score were: age (≥75: 2, 65–74: 1), heart failure (2), female sex (1), hypertension (1), diabetes (1), previous stroke (1). The new score presented an AUC of 0.78 (95% CI 0.78–0.80), the rest of the scores presented lower discrimination ability (P0.05. For the new score, the best cut-off point was 2, with a sensitivity of 82% and specificity of 65.9%, presenting high negative predictive value: 92.9%. Variables OR (CI 95%) P Age (years) 65–74 3.14 (2.29–4.31) Conclusion From the combination of variables with higher predictive value included in the POAF, CHA2DS2-VASc, and HATCH scores, a new risk system was created to predict AFCS, presenting a greater predictive ability than the original ones. Being necessary future prospective validations. |
| تدمد: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehz745.1114 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::c0b9ac62e4ec214004506033eb28524f https://doi.org/10.1093/eurheartj/ehz745.1114 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi...........c0b9ac62e4ec214004506033eb28524f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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| DOI: | 10.1093/eurheartj/ehz745.1114 |