Predicting postoperative atrial fibrillation after cardiac surgery using the Naples prognostic score

Area of Science:

• Cardiology
• Oncology
• Surgical Outcomes

Background:

• The Naples prognostic score (NPS) assesses nutritional and inflammatory status in cancer patients.
• Postoperative atrial fibrillation (POAF) is a common cardiac surgery complication with significant adverse event implications.
• Existing research has explored POAF predictors, but the prognostic value of NPS remains unevaluated.

Purpose of the Study:

• To investigate the Naples prognostic score (NPS) as a predictor for the development of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery.
• To determine if NPS is an independent predictor of POAF.

Main Methods:

• Retrospective case-control study of consecutive cardiac surgery patients (January 2021-December 2023).
• Patients divided into two groups: those who developed POAF and those who maintained sinus rhythm (RSR).
• Univariate and multivariate analyses were performed to identify significant POAF predictors.

Main Results:

• The study included 860 patients (mean age 61.77 years, 77.5% male).
• POAF incidence was 24.8% (214 patients).
• Higher NPS was observed in the POAF group (2.18 ± 0.99) compared to the RSR group (1.96 ± 1.02; P=0.008).
• Multivariate analysis identified advanced age (OR: 1.242) and high NPS (OR: 1.698) as independent predictors of POAF.

Conclusions:

• Elevated NPS is significantly associated with an increased risk of developing POAF.
• Advanced age and high NPS are independent predictors of POAF in cardiac surgery patients.
• NPS demonstrates prognostic value for predicting POAF development post-cardiac surgery.