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Association of Mitral Regurgitation with Postoperative Atrial Fibrillation in Critically Ill Noncardiac Surgery

Jin Zhang1, Jingyi Wang1, Yijia Jiang1

  • 1Surgical Intensive Care Unit, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.

International Journal of General Medicine
|March 7, 2023
PubMed
Abstract

Insights

Mitral regurgitation (MR) is an independent risk factor for postoperative atrial fibrillation (POAF) in critically ill patients undergoing noncardiac surgery. A new MR-based nomogram demonstrates superior prediction of POAF compared to existing scoring systems.

Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Surgical Outcomes

Background:

  • Postoperative atrial fibrillation (POAF) is a significant complication in critically ill patients after noncardiac surgery, yet remains understudied.
  • Mitral regurgitation (MR) is linked to left ventricular dysfunction and may contribute to AF development in the postoperative period.

Purpose of the Study:

  • To investigate the association between mitral regurgitation (MR) and POAF in critically ill patients following noncardiac surgery.
  • To develop and validate a novel nomogram for predicting POAF in this patient population.

Main Methods:

  • A prospective cohort study included 2474 patients undergoing thoracic and general surgery.
  • Preoperative echocardiography, ECG, clinical data, and established scoring systems were analyzed.
  • A nomogram was constructed and validated using logistic regression, ROC, DCA, NRI, and IDI analyses.

Main Results:

  • 8.6% of patients developed POAF within 7 days of ICU admission.
  • The developed MR-nomogram exhibited superior predictive performance for POAF (AUC = 0.824) compared to CHA2DS2-VASc, HATCH, COM-AF, HART, and C2HEST.
  • The MR-nomogram demonstrated significant improvements in predictive value and net benefit.

Conclusions:

  • Mitral regurgitation (MR) is identified as an independent risk factor for POAF in critically ill noncardiac surgery patients.
  • The novel MR-nomogram offers enhanced predictive accuracy for POAF over existing clinical scoring systems.
Keywords:
critically ill patientsmitral regurgitationpostoperative atrial fibrillationpredictive nomogram

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