Mariscalco et al developed scores for predicting the risk of postoperative atrial fibrillation (POAF) after cardiac surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Europe.
Patient selection: cardiac surgery
Outcome: postoperative atrial fibrillation
Parameters:
(1) age in years
(2) COPD
(3) renal status (eGFR in mL per min per 1.73 square meter or dialysis)
(4) emergency surgery
(5) preoperative intra-aortic balloon pump (IABP)
(6) left ventricular ejection fraction in percent
(7) valve surgery
|
Parameter |
Finding |
Beta-Coefficient |
Points |
|
age in years |
< 60 years |
0 |
0 |
|
|
60 to 69 years |
0.715 |
1 |
|
|
70 to 79 years |
1.076 |
2 |
|
|
>= 80 years |
1.372 |
3 |
|
COPD |
absent |
0 |
0 |
|
|
present |
0.286 |
1 |
|
renal status |
eGFR >= 15 and no dialysis |
0 |
0 |
|
|
eGFR < 15 or dialysis |
0.643 |
1 |
|
emergency surgery |
no |
0 |
0 |
|
|
yes |
0.404 |
1 |
|
preoperative IABP |
no |
0 |
0 |
|
|
yes |
0.644 |
1 |
|
LVEF |
>= 30% |
0 |
0 |
|
|
< 30% |
0.369 |
1 |
|
valve surgery |
no |
0 |
0 |
|
|
yes |
0.519 |
1 |
X =
= SUM(points for all 7 beta-coefficients) - 2.032
probability of postoperative atrial fibrillation =
= 1 / (1 + EXP((-1) * X))
total point score =
= SUM(points assigned to all 7 parameters)
Interpretation:
• minimum point score: 0
• maximum point score: 9
• The higher the point score the greater the chances of postoperative atrial fibrillation.
|
Total Score |
Postoperative AF |
|
0 |
11-13% |
|
1 |
20% |
|
2 |
29-30% |
|
3 to 9 |
41-42% |
If the data in Figure is evaluated the line equation is:
probability =
= (0.388 * ((score)^2)) + (7.084 * (score)) + 12.17
Performance:
• The area under the ROC curve was 0.65 in the derivation cohort.
Purpose: To predict postoperative atrial fibrillation (POAF) using the score of Mariscalco et al.
Specialty: Anesthesiology, Cardiology
Objective: risk factors
ICD-10: I97,
