Introduction. Postoperative atrial fibrillation (POAF) is a frequent arrhythmic complication in cardiac surgery. Studies of this potential complication have not been able to elucidate its etiology nor to identify the predictors of its occurrence.
The objective of the study was to evaluate the predictive role of renal dysfunction for POAF in patients undergoing cardiac surgery interventions. We also aimed to determine the role of renal dysfunction in improving diagnostic accuracy of Hypertension, Age, Transitory attack/stroke, Chronic obstructive pulmonary disease, Heart failure (HATCH) score for POAF.
Material and methods. This prospective monocentric observational study included 178 consecutive patients who underwent cardiac surgery interventions in the State University Clinic of Cardiac Surgery of Skopje, Republic of North Macedonia, between September 2017- September 2018. Patients were divided in two groups, according to the absence or occurrence of POAF. HATCH score was calculated and recorded for each patient. A new R-HATCH score was derived by addition of renal dysfunction to the existing HATCH score and its predictive value for POAF was tested and compared to HATCH.
Results. POAF occurred in 90 of 178 patients (50.56%). The average eGFR in the group developing POAF was significantly lower, 78.4±26.9 vs 93.0±29.0 ml/min/1,73m2 (p=0.0005). Patients with GFR <60ml/min/1.73m2 had almost a 5 times greater risk of developing POAF. The addition of renal dysfunction to HATCH score improved its predictive accuracy in our study. The area under the receiver operating characteristic curve increased from 0.73 to 0.76 (p < 0.001).
Conclusions. The addition of preoperative renal dysfunction could improve the diagnostic accuracy of HATCH score for POAF.
Keywords: postoperative atrial fibrillation, renal dysfunction, HATCH score, cardiac surgery.
Address for correspondence:
Marija GJERAKAROSKA RADOVIKJ
State University Clinic of Cardiac Surgery, Faculty of Medicine, Skopje, Republic of North Macedonia
Address: Str. 50 Divizija 6, 1000, Skopje, Republic of North Macedonia