Sá Michel Pompeu Barros de Oliveira, Sá Marcus Villander Barros de Oliveira, Albuquerque Ana Carla Lopes de, Silva Belisa Barreto Gomes da, Siqueira José Williams Muniz de, Brito Phabllo Rodrigo Santos de, Ferraz Paulo Ernando, Lima Ricardo de Carvalho
Rev Bras Cir Cardiovasc. 2012 Jan-Mar;27(1):117-22. doi: 10.5935/1678-9741.20120017.
The aim of this study is to evaluate the applicability of a Brazilian score for predicting atrial fibrillation (AF) in patients undergoing heart valve surgery in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE (Recife, PE, Brazil).
Retrospective study involving 491 consecutive patients operated between May/2007 and December/2010. The registers contained all the information used to calculate the score. The outcome of interest was AF. We calculated association of model factors with AF (univariate analysis and multivariate logistic regression analysis), and association of risk score classes with AF.
The incidence of AF was 31.2%. In multivariate analysis, the four variables of the score were predictors of postoperative AF: age >70 years (OR 6.82; 95%CI 3.34-14.10; P<0.001), mitral valve disease (OR 3.18; 95%CI 1.83-5.20; P<0.001), no use of beta-blocker or discontinuation of its use in the postoperative period (OR 1.63; 95%CI 1.05-2.51; P=0.028), total fluid balance > 1500 ml at first 24 hours (OR 1.92; 95%CI 1.28-2.88; P=0.002). We observed that the higher the risk class of the patient (low, medium, high, very high), the greater is the incidence of postoperative AF (4.2%; 18.1%; 30.8%; 49.2%), showing that the model seems to be a good predictor of risk of postoperative AF, in a statistically significant association (P<0.001).
The Brazilian score proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative AF in patients undergoing heart valve surgery at our institution.
本研究旨在评估巴西评分在巴西累西腓普罗卡佩心脏急救中心心血管外科接受心脏瓣膜手术患者中预测房颤（AF）的适用性。
回顾性研究纳入了2007年5月至2010年12月期间连续接受手术的491例患者。病历记录包含了用于计算该评分的所有信息。感兴趣的结局是房颤。我们计算了模型因素与房颤的关联（单因素分析和多因素逻辑回归分析），以及风险评分类别与房颤的关联。
房颤发生率为31.2%。在多因素分析中，该评分的四个变量是术后房颤的预测因素：年龄>70岁（比值比[OR]6.82；95%置信区间[CI]3.34 - 14.10；P<0.001）、二尖瓣疾病（OR 3.18；95%CI 1.83 - 5.20；P<0.001）、未使用β受体阻滞剂或术后停用（OR 1.63；95%CI 1.05 - 2.51；P = 0.028）、术后24小时总液体平衡>1500 ml（OR 1.92；95%CI 1.28 - 2.88；P = 0.002）。我们观察到患者的风险类别越高（低、中、高、极高），术后房颤的发生率越高（4.2%；18.1%；30.8%；49.2%），表明该模型似乎是术后房颤风险的良好预测指标，具有统计学显著关联（P<0.001）。
巴西评分被证明是一个简单而客观的指标，是我院接受心脏瓣膜手术患者术后房颤发生的满意预测指标。
