Amar et al identified risk factors identifying patients likely to develop atrial fibrillation. This can help identify patients who may benefit from prophylactic therapy. The authors are from Cornell University, Memorial Sloan-Kettering and Northwestern University.
Parameters:
(1) age
(2) preoperative heart rate
(3) postoperative pneumonia and/or respiratory failure
|
Parameters (Pre- and Post-Operative) |
Odds Ratio |
95% CI |
p value |
|
age |
2.5 |
1.7 – 3.4 |
< 0.0001 |
|
heart rate >= 74 beats per minute |
2.1 |
1.3 - 3.5 |
0.0048 |
|
postoperative pneumonia and/or acute respiratory failure |
3.2 |
1.5 – 6.7 |
0.0021 |
from Table 2, page 354
where:
• The authors state on page 354 that the addition of pneumonia or acute respiratory failure to a logistic regression model did not significantly enhance the ability to predict the occurrence of atrial fibrillation.
• It might be interesting to see if a person at risk for postoperative pneumonia and/or respiratory failure had a higher risk of atrial fibrillation.
|
Age |
Odds Ratio |
|
< 60 vs 60 - 69 |
2.5 |
|
60 – 69 vs > 70 |
2.5 |
|
< 60 vs > 70 |
2.5 * 2.5 = 6.25 |
|
Age |
Percent with Postoperative Atrial Fibrillation |
|
< 50 years |
4% |
|
50 – 59 years |
8% |
|
60 – 69 years |
14% |
|
>= 70 years |
25% |
from Figure 1, page 354
|
Heart Rate |
Percent with Postoperative Atrial Fibrillation |
|
< 60 beats per minute |
6% |
|
60 – 73 beats per minute |
12% |
|
74 – 90 beats per minute |
21% |
|
> 90 beats per minute |
14% |
from Figure 2, page 354
Performance:
• Presence of both age > 60 years of age and heart rate >= 74 beats per minute was 73% sensitive and 57% specific for development of atrial fibrillation.
Specialty: Anesthesiology, Cardiology
