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左心房容积指数和白细胞介素-6 可预测术后心房颤动。

Left atrial volume index and interleukin-6 as predictors for postoperative atrial fibrillation.

机构信息

Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, Jiangsu Province, 210006, China.

出版信息

J Cardiothorac Surg. 2024 Jun 7;19(1):325. doi: 10.1186/s13019-024-02813-9.

Abstract

BACKGROUND

Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. However, the predictive value of single indictor still remains controversial. This study aimed to assess the predictive value of combining preoperative left atrial volume index (LAVI) and postoperative interleukin-6 (IL-6) for POAF in the patients receiving cardiac surgery.

METHODS

Patients who admitted to Nanjing First Hospital during the study period between December 2022 and June 2023, and underwent open-heart surgery without a history of atrial fibrillation (AF) were enrolled. The relationships between predictors and POAF were investigated using logistic regression analysis. We determined the combined predictive value of LAVI and IL-6 for POAF by measuring the changes in the area under the receiver operating characteristic curve (AUC) and calculating the net reclassification improvements (NRIs) and integrated discrimination improvement (IDIs).

RESULTS

102 patients were enrolled in this study, and 50 participants developed POAF (49.0%). Patients who experienced POAF had higher levels of preoperative LAVI and postoperative IL-6 than those who did not. Regression analysis revealed that larger LAVI and higher level of IL-6 were independently associated with increased risk of POAF. The combined addition of LAVI and IL-6 to the predictive model resulted in an evident increase in the AUC. Incorporating both LAVI and IL-6 increased IDIs in all models.

CONCLUSION

Our results demonstrated that combined LAVI and IL-6 achieved a higher prediction performance for POAF.

摘要

背景

术后心房颤动(POAF)是心脏手术后的一种常见并发症。然而,单一指标的预测价值仍存在争议。本研究旨在评估术前左心房容积指数(LAVI)和术后白细胞介素-6(IL-6)联合用于接受心脏手术的患者 POAF 的预测价值。

方法

本研究纳入了 2022 年 12 月至 2023 年 6 月期间在南京第一医院接受开胸手术且无心房颤动(AF)病史的患者。使用逻辑回归分析研究预测因子与 POAF 之间的关系。我们通过测量接受者操作特征曲线(ROC)下面积(AUC)的变化以及计算净重新分类改善(NRIs)和综合判别改善(IDIs)来确定 LAVI 和 IL-6 联合预测 POAF 的联合预测价值。

结果

本研究共纳入 102 例患者,其中 50 例患者发生 POAF(49.0%)。发生 POAF 的患者术前 LAVI 和术后 IL-6 水平高于未发生 POAF 的患者。回归分析显示,较大的 LAVI 和较高的 IL-6 水平与 POAF 风险增加独立相关。将 LAVI 和 IL-6 联合添加到预测模型中,AUC 明显增加。在所有模型中,同时包含 LAVI 和 IL-6 增加了 IDIs。

结论

我们的结果表明,联合 LAVI 和 IL-6 可提高 POAF 的预测性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03e5/11157838/b5c96ad23641/13019_2024_2813_Fig1_HTML.jpg

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