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The Role of the CHA2DS2-VASc Score in predicting postoperative Atrial Fibrillation after pulmonary resection
Hasan Ekrem Camas1, Serap Yildirim2, Suleyman Emre Akin3
1Hasan Ekrem Camas Assistant Professor, Faculty of Medicine, Department of Thoracic Surgery, Suleyman Demirel University, Isparta, Turkiye.
Insights
The CHA2DS2-VASc score can predict the risk of developing atrial fibrillation (AF) after lung surgery. Higher scores indicate a greater likelihood of postoperative AF, enabling early identification of high-risk patients.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Informatics
Background:
- Atrial fibrillation (AF) is a common complication after thoracic surgery.
- The CHA2DS2-VASc score is established for assessing thromboembolic risk in AF patients.
- Predicting postoperative AF (PAF) risk in patients undergoing lung resection is crucial for management.
Purpose of the Study:
- To investigate the association between the CHA2DS2-VASc score and the incidence of PAF in patients undergoing elective anatomical lung resection.
- To determine if the CHA2DS2-VASc score can serve as a predictive tool for PAF in this specific surgical population.
Main Methods:
- Retrospective cohort study including patients who underwent elective anatomic lung resection.
- Calculation of CHA2DS2-VASc scores for all included patients.
- Statistical analyses included Mann-Whitney U, Chi-square, ROC analysis, and binary logistic regression.
Main Results:
- The incidence of PAF was 11% among 100 patients.
- Patients who developed PAF had significantly higher CHA2DS2-VASc scores (p<0.001).
- ROC analysis demonstrated an AUC of 0.797, with a CHA2DS2-VASc score cutoff of 1.5 predicting PAF with 90.9% sensitivity.
Conclusions:
- The CHA2DS2-VASc score is a significant predictor of PAF following thoracic surgery.
- This scoring system can identify patients at high risk for PAF, allowing for targeted prophylactic interventions.
- Utilizing the CHA2DS2-VASc score may help reduce postoperative morbidity and mortality.
Objective:
CHA2DS2-VASc is a validated scoring system used to calculate the risk of stroke and thrombus in atrial fibrillation (AF) conditions. In this study, we aimed to evaluate the relationship between the development of postoperative atrial fibrillation (PAF) and CHA2DS2-VASc score in patients undergoing elective anatomical lung resection.
Methodology:
In this retrospective cohort study, the records of patients who underwent elective anatomic lung resection at a single center between January 2015 to December 2024 were reviewed. The CHA2DS2-VASc score of all patients was calculated. Mann-Whitney U, Chi-square and ROC analyses, as well as binary logistic regression, were used for statistical analysis.
Results:
Among one hundred patients (80 males), the incidence of PAF was 11%. Patients with PAF had significantly higher CHA2DS2-VASc scores (p<0.001). ROC analysis showed an AUC of 0.797 (p<0.001), with a cut-off of 1.5 yielding 90.9% sensitivity and 34.8% specificity. Logistic regression identified the CHA2DS2-VASc score as a significant predictor of PAF (OR=4.33, p=0.039).
Conclusion:
The CHA2DS2-VASc score may be a valuable tool not only to assess thromboembolic risk but also to predict the development of PAF after thoracic surgery. With this scoring, high-risk patients can be identified in advance, appropriate prophylactic measures can be taken, and postoperative morbidity and mortality can be reduced.
