Postoperative Atrial Fibrillation After Noncardiac Surgery and Stroke —Reply

In Reply Dr Hu and colleagues argue that the CHA2DS2-VASc score rather than the Charlson Comorbidity Index should have been used for adjustment in the outcome comparisons between the groups with and without postoperative AF in our study. Conceptually, we selected the Charlson Comorbidity Index because it captures multimorbidity more comprehensively, as opposed to the CHA2DS2-VASc score, which incorporates only a few select variables. The effect of multimorbidity would be most important in a postoperative and elderly population such as the population in our cohort. It should also be noted that the CHA2DS2-VASc score was developed for stroke prediction in community-dwelling populations with AF, rather than in patients with postoperative AF; therefore, it would also have limitations when used in this setting. Regardless, we repeated the outcomes analyses adjusting for the CHA2DS2-VASc score as a whole as well as adjusting for the score ’s component variables individually. The results are very consistent and comparable with the analyses adjusting for the Charlson Comorbidity Index (Table).
Source: JAMA - Category: General Medicine Source Type: research