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Preoperative CHA2 DS2 -VASc Score Predicts Postoperative Atrial Fibrillation after Lobectomy.

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Titel: Preoperative CHA2 DS2 -VASc Score Predicts Postoperative Atrial Fibrillation after Lobectomy.
Autoren: Lee, Charles T., Strauss, David M., Stone, Lauren E., Stoltzfus, Jill C., Puc, Matthew M., Burfeind, William R.
Quelle: Thoracic & Cardiovascular Surgeon; 2019, Vol. 67 Issue 2, p125-130, 6p
Schlagwörter: LOBECTOMY (Lung surgery), ATRIAL fibrillation
Abstract: Background Postoperative atrial fibrillation (POAF) affects 10 to 20% of noncardiac thoracic surgeries and increases patient morbidity and costs. The purpose of this study is to determine if preoperative CHA2 DS2-VASc score can predict POAF after pulmonary lobectomy for nonsmall cell lung cancer. Methods Patients with complete CHA2 DS2-VASc data who underwent lobectomies from January 2007 to January 2016 at a single institution were analyzed in a retrospective case–control study using a prospective database. An independent samples t -test was used to compare the mean CHA2 DS2-VASc scores of POAF and non-POAF groups. A multivariable logistic regression analysis (MVA) evaluated the independent contribution of variables of the CHA2 DS2-VASc score in predicting POAF. Chi-square test with univariate odds ratios (ORs) was used to determine a statistically significant cutoff score for predicting POAF. Results Of 525 total patients, 82 (15.6%) developed POAF (mean CHA2 DS2-VASc score: 2.7) and 443 (84.4%) did not develop POAF (mean score: 2.3). Mean difference between these groups was significant at 0.43 (p = 0.01; 95% confidence interval [CI]: 0.09–0.76). In the MVA, significant predictors of POAF were age 65 to 74 years (adjusted OR [aOR] = 2.45; 95% CI: 1.31–4.70; p = 0.006) and age ≥75 years (aOR = 3.11; 95% CI: 1.62–5.95; p = 0.0006). Patients with CHA2 DS2-VASc scores ≥5 had significantly increased OR for POAF (OR = 2.59; 95% CI: 1.22–5.50). Conclusions Preoperatively calculated CHA2 DS2-VASc score can predict POAF in patients undergoing pulmonary lobectomy. Age is the most statistically significant independent predictor, and patients with scores ≥5 have significantly increased risk. Trials for POAF prophylaxis should target this population. [ABSTRACT FROM AUTHOR]
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Datenbank: Complementary Index
Beschreibung
Abstract:Background Postoperative atrial fibrillation (POAF) affects 10 to 20% of noncardiac thoracic surgeries and increases patient morbidity and costs. The purpose of this study is to determine if preoperative CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc score can predict POAF after pulmonary lobectomy for nonsmall cell lung cancer. Methods Patients with complete CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc data who underwent lobectomies from January 2007 to January 2016 at a single institution were analyzed in a retrospective case–control study using a prospective database. An independent samples t -test was used to compare the mean CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc scores of POAF and non-POAF groups. A multivariable logistic regression analysis (MVA) evaluated the independent contribution of variables of the CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc score in predicting POAF. Chi-square test with univariate odds ratios (ORs) was used to determine a statistically significant cutoff score for predicting POAF. Results Of 525 total patients, 82 (15.6%) developed POAF (mean CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc score: 2.7) and 443 (84.4%) did not develop POAF (mean score: 2.3). Mean difference between these groups was significant at 0.43 (p = 0.01; 95% confidence interval [CI]: 0.09–0.76). In the MVA, significant predictors of POAF were age 65 to 74 years (adjusted OR [aOR] = 2.45; 95% CI: 1.31–4.70; p = 0.006) and age ≥75 years (aOR = 3.11; 95% CI: 1.62–5.95; p = 0.0006). Patients with CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc scores ≥5 had significantly increased OR for POAF (OR = 2.59; 95% CI: 1.22–5.50). Conclusions Preoperatively calculated CHA<subscript>2</subscript> DS<subscript>2</subscript>-VASc score can predict POAF in patients undergoing pulmonary lobectomy. Age is the most statistically significant independent predictor, and patients with scores ≥5 have significantly increased risk. Trials for POAF prophylaxis should target this population. [ABSTRACT FROM AUTHOR]
ISSN:01716425
DOI:10.1055/s-0038-1675638