MO423: Does Renal Dysfunction Improve the Predictive Value of Hatch Score for Postoperative Atrial Fibrillation?

Abstract

Abstract BACKGROUND AND AIMS Postoperative atrial fibrillation (POAF) is a frequent arrhythmic complication in cardiac surgery. Studies of this potential complication have not been able to elucidate its aetiology nor to identify the predictors of its occurrence. The aim of this study was to evaluate the predictive role of a renal dysfunction for POAF in patients undergoing cardiac surgery interventions. We also aimed to determine the role of renal dysfunction in improving the diagnostic accuracy of hypertension, age, transitory attack/stroke, chronic obstructive pulmonary disease, heart failure (HATCH) score for POAF. METHOD This prospective monocentric observational study included 178 consecutive patients who underwent cardiac surgery interventions in the State University Clinic for Cardiac Surgery of Skopje, Republic of North Macedonia, between September 2017 and September 2018. Patients were divided into 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 the 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 90/178 patients (50.56%). The average estimated glomerular filtration rate (eGFR) in the group developing POAF was significantly lower, 78.4 ± 26.9 versus 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). CONCLUSION The addition of preoperative renal dysfunction could improve the diagnostic accuracy of HATCH score for POAF.