Risk factors analysis and nomogram model construction for postoperative atrial fibrillation after off-pump coronary artery bypass grafting.

Abstract

Objective: To explore the risk factors associated with postoperative atrial fibrillation (POAF) after off-pump coronary artery bypass grafting (OPCABG) and to construct a nomogram predictive model.

Methods: In this retrospective cohort study, clinical data of 193 patients who received OPCABG in Huai'an First People's Hospital Affiliated to Nanjing Medical University from June 2021 to November 2023 were retrospectively analyzed. Based on the established diagnosis of POAF, patients were divided into the POAF group (n=75) and the non-POAF group (n=118). Logistic regression analysis was used to screen for risk factors for POAF after OPCABG. A nomogram prediction model for POAF after OPCABG was constructed based on the independent risk factors, and the model was validated by calibration curve and the area under the receiver operating characteristic curve (AUC).

Results: The incidence of POAF after OPCABG in the cohort was 38.86% (75/193). Age, diabetes, history of percutaneous coronary intervention (PCI), duration of operation, length of hospital stay and left ventricular ejection fraction (LVEF) were identified as independent risk factors for POAF after OPCABG (P<0.05). The concordance index of the nomogram model for predicting the risk of after POAF after OPCABG based on the six independent risk factors was 0.820. The correction curve tended towards the ideal curve, and the area under the receiver operating characteristic curve was 0.820 (95% CI:0.758~0 882).

Conclusions: Age, diabetes, history of PCI, duration of operation, length of hospital stay and LVEF are independent risk factors for POAF after OPCABG. The constructed nomogram model has a good predictive performance for predicting POAF in patients after OPCABG.