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

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.