Key result
A novel PSCC-AF score predicted postoperative atrial fibrillation after mitral valve surgery with an AUCROC of 0.67, significantly outperforming the existing POAF score (AUCROC 0.61; p=0.009).
Why the study?
Postoperative atrial fibrillation increases morbidity and mortality after cardiac surgery, but existing risk scores have shown variable performance in predicting it after mitral valve surgery.
Do clinical risk scores accurately predict postoperative atrial fibrillation in patients undergoing mitral valve surgery?
Cohort (n=1,381)
Do clinical risk scores accurately predict postoperative atrial fibrillation in patients undergoing mitral valve surgery?
p-value: p=0.009
A newly developed PSCC-AF score based on preoperative characteristics showed modest but superior predictive ability for postoperative atrial fibrillation after mitral valve surgery compared to existing scores.
PSCC-AF modestly improves POAF prediction after mitral valve surgery; leaves open clinical utility pending external validation.
Background Atrial fibrillation after cardiac surgery (POAF) is associated with increased morbidity and mortality. Several scores were used to predict POAF, with variable results. Thus, this study assessed the performance of several scoring systems to predict POAF after mitral valve surgery. Additionally, we identified the risk factors for POAF in those patients. Methods This retrospective cohort included 1381 recruited from 2009 to 2021. The patients underwent mitral valve surgery, and POAF occurred in 233 (16.87%) patients. The performance of CHADS2, CHA2DS2‐VASc, POAF, EuroSCORE II, and HATCH scores was evaluated. Results The median age was higher in patients who developed POAF (60 vs. 54 years; p < .001). CHA2‐DS2‐VASc, POAF, EuroSCORE II, and HATCH scores significantly predicted POAF, with areas under the curve of the receiver operator curve (AUCROC) of 0.56, 0.61, 0.58, and 0.54, respectively. We identified age > 58 years, body mass index > 28 kg/m2, creatinine clearance < 90 mL/min, reoperative surgery, and preoperative inotropic and intra‐aortic balloon pump use as predictors of POAF. We constructed a score from these variables (PSCC‐AF). A score > 2 significantly predicted POAF (p < .001). The AUCROC of this score was 0.67, which was significantly higher than the AUCROC of the POAF score (p = .009). Conclusion POAF after mitral valve surgery can be predicted based on preoperative patient characteristics. The new PSCC‐AF score significantly predicted POAF after mitral valve surgery and can serve as a bedside diagnostic tool for POAF risk screening. Further studies are needed to validate the PSCC‐AF‐mitral score externally.
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Albabtain et al. (2024) conducted a cohort in Atrial fibrillation after mitral valve surgery (n=1,381). PSCC-AF score vs. POAF score was evaluated on Prediction of postoperative atrial fibrillation (p=0.009). A novel PSCC-AF score predicted postoperative atrial fibrillation after mitral valve surgery with an AUCROC of 0.67, significantly outperforming the existing POAF score (AUCROC 0.61; p=0.009).
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