使用HARMS2-AF评分预测术后房颤

Predicting Postoperative Atrial Fibrillation Using HARMS2-AF Score.

作者信息

Öncel Can Ramazan, Köseoğlu Cemal, Dağaşan Göksel, Çoner Ali, Ayhan Selçuk, Akkaya Özgür, Karahan Oğuz

机构信息

Department of Cardiology, Alanya Alaaddin Keykubat University, Faculty of Medicine, Antalya, Türkiye.

Department of Cardiology, Alanya Training and Research Hospital, Antalya, Türkiye.

出版信息

Anatol J Cardiol. 2024 Sep 18;28(11):550-4. doi: 10.14744/AnatolJCardiol.2024.4470.

DOI:10.14744/AnatolJCardiol.2024.4470

PMID:39292154

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11537452/

Abstract

BACKGROUND

Postoperative atrial fibrillation (POAF) remains a common complication after cardiac surgery. The ability to accurately identify patients at risk through previous risk scores is limited. This study aimed to evaluate the new HARMS2-AF risk score to predict POAF after coronary artery bypass grafting (CABG) surgery.

METHODS

In this retrospective cohort study, we included 265 patients undergoing CABG surgery from 2022-2023. Data were obtained from the medical files of the patients and hospital records. Each patient was assigned a HARMS2-AF risk score. A univariate and multivariate regression analyses were done to analyze independent predictors of POAF.

RESULTS

Of 265 patients, 49 had postoperative atrial fibrillation. HARMS2-AF score was significantly higher in patients with POAF. Age, sleep apnea,a left atrial diameter (LAd), and HARMS2-AF score were independently associated with POAF. A HARMS2-AF score ≥ 4.5 predicted POAF with 91% sensitivity and 64% specificity (AUC = 0.787, 95% CI = 0.731-0.842, P < .001).

CONCLUSION

The HARMS2-AF score is a strong predictor of atrial fibrillation (AF) development after isolated CABG surgery. It can be used as a novel stratification tool to estimate AF after cardiac surgery.

摘要

背景

术后房颤（POAF）仍是心脏手术后常见的并发症。通过既往风险评分准确识别高危患者的能力有限。本研究旨在评估新的HARMS2-AF风险评分，以预测冠状动脉旁路移植术（CABG）后的POAF。

方法

在这项回顾性队列研究中，我们纳入了2022年至2023年接受CABG手术的265例患者。数据来自患者的病历和医院记录。为每位患者分配一个HARMS2-AF风险评分。进行单因素和多因素回归分析，以分析POAF的独立预测因素。

结果

265例患者中，49例发生术后房颤。POAF患者的HARMS2-AF评分显著更高。年龄、睡眠呼吸暂停、左心房直径（LAd）和HARMS2-AF评分与POAF独立相关。HARMS2-AF评分≥4.5预测POAF的敏感性为91%，特异性为64%（AUC = 0.787，95%CI = 0.731-0.842，P <.001）。