Oksen Dogac, Guven Baris, Donmez Ayca, Yesiltas Mehmet Ali, Koyuncu Ahmet Ozan, Gulbudak Seran, Oktay Veysel
Department of Cardiology, Altinbas University.
Department of Cardiology, Istanbul University - Cerrahpasa Institute of Cardiology.
Coron Artery Dis. 2025 May 1;36(3):225-231. doi: 10.1097/MCA.0000000000001438. Epub 2024 Oct 24.
The Naples prognostic score (NPS) is a novel indicator of nutritional and inflammatory statuses in cancer patients. Development of atrial fibrillation after cardiac surgery (POAF) is a common complication that increases the incidence of adverse events. Numerous studies have investigated predictors of POAF. Yet, this study is the first to evaluate the prognostic value of NPS in predicting the development of POAF.
The population of this retrospective single-center case-control study consisted of all consecutive patients who underwent cardiac surgery between January 2021 and December 2023. The patients included in the study sample were divided into two groups according to whether they had POAF (group POAF) or remained in sinus rhythm (group RSR). Univariate and multivariate analyses were conducted to identify the variables that significantly predicted the development of POAF.
This study consisted of 860 patients with a mean age of 61.77 ± 9.13 years and 77.5% ( n = 667) were male. The incidence of POAF in the sample was 24.8% ( n = 214). NPS was significantly higher in group POAF than in group RSR (2.18 ± 0.99 vs. 1.96 ± 1.02, P = 0.008). Multivariate analysis revealed age [odds ratio (OR): 1.242, 95% confidence interval (CI): 1.020-1.304, P < 0.001] and high NPS (OR: 1.698, 95% CI: 1.121-1.930, P < 0.010) as independent predictors of POAF.
High NPS values, along with advanced age, were found to be strongly associated with an increased risk of developing POAF. Therefore, it is concluded that NPS is a significant and independent predictor of POAF in patients undergoing cardiac surgery.
那不勒斯预后评分（NPS）是癌症患者营养和炎症状态的一种新指标。心脏手术后发生房颤（POAF）是一种常见并发症，会增加不良事件的发生率。许多研究已经调查了POAF的预测因素。然而，本研究是首次评估NPS在预测POAF发生方面的预后价值。
这项回顾性单中心病例对照研究的人群包括2021年1月至2023年12月期间所有连续接受心脏手术的患者。根据患者是否发生POAF（POAF组）或维持窦性心律（RSR组），将纳入研究样本的患者分为两组。进行单因素和多因素分析以确定显著预测POAF发生的变量。
本研究包括860例患者，平均年龄为61.77±9.13岁，77.5%（n = 667）为男性。样本中POAF的发生率为24.8%（n = 214）。POAF组的NPS显著高于RSR组（2.18±0.99对1.96±1.02，P = 0.008）。多因素分析显示年龄[比值比（OR）：1.242，95%置信区间（CI）：1.020 - 1.304，P < 0.001]和高NPS（OR：1.698，95% CI：1.121 - 1.930，P < 0.010）是POAF的独立预测因素。
发现高NPS值与高龄一起与发生POAF的风险增加密切相关。因此，得出结论，NPS是心脏手术患者POAF的重要且独立的预测因素。
