Development and validation of a novel predicting nomogram for new-onset postoperative atrial fibrillation following isolated aortic valve replacement
10.7507/1007-4848.202308040
- VernacularTitle:单纯主动脉瓣置换术后新发心房颤动风险的新型列线图预测模型建立与验证
- Author:
Rui LI
1
;
Hanqing LIANG
2
;
Jinsong HAN
3
Author Information
1. 1. General Hospital of Northern Theater Command, The Graduate Training Base of China Medical University, Shenyang, 110016, P. R. China 2. Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
2. Department of Cardiothoracic Surgery, Xuzhou Hospital, Xuzhou Medical University, Xuzhou, 221000, Jiangsu, P. R. China
3. Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
- Publication Type:Journal Article
- Keywords:
Isolated aortic valve replacement;
nomogram prediction model;
postoperative atrial fibrillation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(08):1151-1158
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish and validate a nomogram model for predicting the risk of new-onset postoperative atrial fibrillation (POAF) after isolated aortic valve replacement (AVR). Methods The clinical data of patients without atrial fibrillation (AF) who underwent isolated AVR in the General Hospital of the Northern Theater of Command from June 2020 to June 2022 were retrospectively collected. Patients with AVR were divided into a POAF group and a non-POAF group according to whether POAF occurred within 7 days after surgery. The preoperative baseline data, blood indexes, color Doppler echocardiography and the heart rate variability (HRV) in 7 days before surgery were analyzed. Logistic regression was used to analyze the preoperative risk factors for POAF and R language was used to construct a nomogram to predict POAF. The results were compared with the established AF model (POAF-AF score). Results A total of 191 patients were enrolled in this study, and 66 (35%) of them developed POAF within 7 days after the surgery. The age of the patients in the POAF group was (60.97±8.41) years and 16 (24%) were female, while the age of the patients in the non-POAF group was (54.65±11.85) years and 59 (47%) were female. Univariate and multivariate logistic regression analysis showed that age, sex, drinking history, chronic obstructive pulmonary disease, plateletocrit and high frequency power were independently associated with POAF after the AVR. The nomogram of POAF was constructed by combining the above independent risk factors. We predicted the area under receiver operating characteristic curve (AUC=0.812) in the nomogram of POAF after simple aortic valve replacement. The model was internally verified by a 10-fold cross-validation resampling (AUC=0.757, Kappa=0.438). Compared with the POAF-AF score, the nomogram had a superior discrimination performance. Conclusion Age, sex, drinking history, chronic obstructive pulmonary disease, plateletocrit, and high frequency power are independent predictors for POAF after isolated AVR. The nomogram can be used as a practical tool to help clinicians predict the probability of individual POAF occurrence and take necessary preventive measures.
