Prediction rule for atrial fibrillation after major noncardiac thoracic surgery Journal Article


Authors: Passman, R. S.; Gingold, D. S.; Amar, D.; Lloyd-Jones, D.; Bennett, C. L.; Zhang, H.; Rusch, V. W.
Article Title: Prediction rule for atrial fibrillation after major noncardiac thoracic surgery
Abstract: Background. Atrial fibrillation (AF) is a common complication after major noncardiac thoracic surgery and increases the cost and morbidity of these operations. We sought to derive and validate a clinical prediction rule to risk-stratify patients for postoperative AF. Methods. For a cohort of cancer patients who underwent noncardiac thoracic surgery, we examined the association of preoperative clinical variables with development of postoperative AF. Logistic regression identified multivariable predictors of AF and a clinical risk score was developed by assigning weighted point scores for the presence of each significant covariate. An independent data set was used for validation purposes. Results. Of the 856 patients, 147 (17.2%) developed postoperative AF. Male gender (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1 to 2.4), advanced age (55 to 74 years OR 4.4, 95% CI 2.0 to 9.8; ≥ 75 years OR 9.2, 95% CI 3.9 to 21.5), and preoperative heart rate greater than or equal to 72 beats per minute (OR 1.7, 95% CI 1.2 to 2.5) were independent predictors of postoperative AF. A risk score was assigned with male gender and heart rate greater than or equal to 72 beats per minute each receiving 1 point, and age 55 to 74 and greater than or equal to 75 years receiving 3 and 4 points, respectively. The risk of postoperative AF ranged from 0% (0 points) to 54.6% (6 points) (p < 0.001). The score-based risk in both derivation and validation sets was similar (P = 0.66). Conclusions. A prediction rule using clinical variables can be used to predict the risk of postoperative AF after noncardiac thoracic surgery. This information can be used to guide prophylactic therapy. © 2005 by The Society of Thoracic Surgeons.
Keywords: pneumonectomy; age; gender; lung-cancer; prognostic-significance; risk-factors; arrhythmias; prophylactic; operations; supraventricular tachyarrhythmias; digitalization
Journal Title: Annals of Thoracic Surgery
Volume: 79
Issue: 5
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2005-01-01
Start Page: 1698
End Page: 1703
Language: English
DOI: 10.1016/j.athoracsur.2004.10.058
ACCESSION: WOS:000228876300037
PROVIDER: wos
PUBMED: 15854958
Notes: --- - Article; Proceedings Paper - 40th Annual Meeting of the Society-of-Thoracic-Surgeons - JAN 26-28, 2004 - San Antonio, TX - "Source: Wos"
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MSK Authors
  1. Valerie W Rusch
    757 Rusch
  2. David Amar
    125 Amar
  3. Hao Zhang
    54 Zhang