Prediction of new onset postoperative atrial fibrillation using a simple Nomogram

作者：Siming Zhu, Hebin Che, Yunlong Fan, S Jiang · 发表于：Journal of Cardiothoracic Surgery · 年份：2023 · DOI：10.1186/s13019-023-02198-1 · 被引用次数：11 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac, Anesthesia and Surgical Outcomes、Heart Failure Treatment and Management

BACKGROUND: New onset postoperative atrial fibrillation (POAF) is the most common complication of cardiac surgery, with an incidence ranging from 15 to 50%. This study aimed to develop a new nomogram to predict POAF using preoperative and intraoperative risk factors. METHODS: We retrospectively analyzed the data of 2108 consecutive adult patients (> 18 years old) who underwent cardiac surgery at our medical institution. The types of surgery included isolated coronary artery bypass grafting, valve surgery, combined valve and coronary artery bypass grafting (CABG), or aortic surgery. Logistic regression or machine learning methods were applied to predict POAF incidence from a subset of 123 parameters. We also developed a simple nomogram based on the strength of the results and compared its predictive ability with that of the CHA2DS2-VASc and POAF scores currently used in clinical practice. RESULTS: POAF was observed in 414 hospitalized patients. Logistic regression provided the highest area under the receiver operating characteristic curve (ROC) in the validation cohort. A simple bedside tool comprising three variables (age, left atrial diameter, and surgery type) was established, which had a discriminative ability with a ROC of 0.726 (95% CI 0.693-0.759) and 0.727 (95% CI 0.676-0.778) in derivation and validation subsets respectively. The calibration curve of the new model was relatively well-fit (p = 0.502). CONCLUSIONS: Logistic regression performed better than machine learn...