Clinical utility of CHADS₂ and CHA₂DS₂-VASc scoring systems for predicting postoperative atrial fibrillation after cardiac surgery

详细信息    查看全文

• 作者：Su-Kiat Chua ; Kou-Gi Shyu ; Ming-Jen Lu ; Li-Ming Lien ; Chia-Hsun Lin ; Hung-Hsing Chao ; Huey-Ming Lo
• 关键词：23.1 ; 24
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：146
• 期：4
• 页码：919-926.e1
• 全文大小：592 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Objectives

The presence of postoperative atrial fibrillation predicts a higher short- and long-term mortality rates; however, no scoring system has been used to discriminate patients at high risk for this complication. The aim of this study was to investigate whether the CHADS₂ and CHA₂DS₂-VASc scores are useful risk assessment tools for new-onset atrial fibrillation after cardiac surgery.

Methods

A total of 277 consecutive patients who underwent cardiac surgery were prospectively included in this risk stratification study. We calculated the CHADS₂ and CHA₂DS₂-VASc scores from the data collected. The primary end point was the development of postoperative atrial fibrillation within 30?days after cardiac surgery.

Results

Eighty-four (30 % ) of the patients had postoperative atrial fibrillation at a median of 2?days (range, 0-27?days) after cardiac surgery. The CHADS₂ and CHA₂DS₂-VASc scores were significant predictors of postoperative atrial fibrillation in separate multivariate regression analyses. The Kaplan-Meier analysis obtained a higher postoperative atrial fibrillation rate when based on the CHADS₂ and CHA₂DS₂-VASc scores of at least 2 than when based on scores less than 2 (both log rank, P?<?.001). In addition, the CHA₂DS₂-VASc scores could be used to further stratify the patients with CHADS₂ scores of 0 or 1 into 2 groups with different postoperative atrial fibrillation rates at a cutoff value of 2 (12 % vs 32 % ; P?=?.01).

Conclusions

CHADS₂ and CHA₂DS₂-VASc scores were predictive of postoperative atrial fibrillation after cardiac surgery and may be helpful for identifying high-risk patients.