Clinical utility of CHADS2 and CHA2DS2-VASc scoring systems for predicting postoperative atrial fibrillation after cardiac surgery
Su-Kiat Chua, Kou-Gi Shyu, Ming-Jen Lu, Li-Ming Lien, Chia-Hsun Lin, Hung-Hsing Chao, Huey-Ming Lo, Su-Kiat Chua, Kou-Gi Shyu, Ming-Jen Lu, Li-Ming Lien, Chia-Hsun Lin, Hung-Hsing Chao, Huey-Ming Lo
Abstract
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.
Keywords: 23.1; 24; AF; CABG; CI; E; LV; LVEDD; LVM; OR; PAD; POAF; PWTD; SWTD; TIA; atrial fibrillation; confidence interval; coronary artery bypass grafting; early mitral inflow velocity; e′; interventricular septal wall thickness; left ventricular; left ventricular end-diastolic diameter; left ventricular mass; medial mitral annular velocity during passive filling; odds ratio; peripheral arterial disease; posterior wall thickness; postoperative atrial fibrillation; transient ischemic attack.
Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Source: PubMed