The Role of the CHA₂DS₂-VASc Score in predicting postoperative Atrial Fibrillation after pulmonary resection

Abstract

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 since 2015 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 100 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.