Establishment of clinical model for predicting the risk of atrial fibrillation with gastroesophageal reflux disease

doi:10.3877/cma.j.issn.2095-8765.2024.03.004

Abstract

Abstract:

Objective

To explore the influencing factors of atrial fibrillation in patients with gastroesophageal reflux disease （GERD）, and to establish a clinical model to predict the risk of atrial fibrillation in patients with GERD.

Methods

We collected the data of 268 patients diagnosed with GERD from 2015 to 2017 in the People's Hospital of Xinjiang Uygur Autonomous Region. According to the patients' condition, we divided them into GERD with atrial fibrillation group and GERD group. The influencing factors of atrial fibrillation in patients with GERD were identified by univariate regression and multivariate regression. A clinical prediction model for predicting atrial fibrillation in GERD patients was established by nomogram method, and a scoring scale was established according to the prediction model.After that, 75% of the participating patients were used as the modeling group and the remaining 25% as the verification group, the observed model was verified externally. Meanwhile, ROC curve was drawn, AUC was calculated, and DCA curve was drawn to further verify the built scale internally.

Results

Among 268 patients with GERD, 35 patients were complicated with atrial fibrillation. Univariate and multivariate logistic regression models were used to analyze the influence of related indexes on atrial fibrillation in patients with GERD. It was found that age, BMI, coronary heart disease or heart failure, and sleep apnea could significantly affect atrial fibrillation in GERD （P＜0.05）, but gender, nationality, diabetes, smoking and hypertension had no significant influence （P＞）. Further trend test showed that the risk of atrial fibrillation increased gradually with the increase of age and BMI （P for trend＜0.05）. Then a clinical prediction model was established. The AUC of the patients in the modeling group was 0.6858, while that in the external verification group was 0.6473. There was no significant difference between the two groups （P＞0.05）, and the C index of the model was 0.7041.

Conclusion

Age, BMI, coronary heart disease or heart failure, sleep apnea, etc. can significantly affect the occurrence of atrial fibrillation in GERD. At the same time, we initially constructed a practical and effective clinical model to predict atrial fibrillation in patients with GERD.

Key words: Gastroesophageal reflux disease, Atrial fibrillation, Risk factors, Clinical prediction model

Ming Wen, Li Zhang, Fang Xie, Aili Aikebaier, Abudureyimu Kelimu. Establishment of clinical model for predicting the risk of atrial fibrillation with gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(03): 130-136.

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https://zhwsgflbdzzz.cma-cmc.com.cn/EN/Y2024/V11/I03/130

Figures/Tables 6

指标	AF		χ ²/Z值	P值
指标	+（35例）	-（233例）	χ ²/Z值	P值
性别［例（%）］			0.074	0.78
男性	22（61.76）	137（58.95）
女性	13（38.24）	96（41.05）
年龄（岁， $\bar{x}$ ±s）	63.54±8.04	46.28±4.96	12.35	＜0.001
体质量指数（kg/m²， $\bar{x}$ ±s）	27.17±4.36	27.87±4.74	0.87	0.39
民族［例（%）］			0.34	0.84
汉族	28（80.00）	182（78.11）
维吾尔族	6（17.14）	39（16.73）
其他［例（%）］	1（2.86）	12（5.16）
糖尿病	16（45.71）	106（45.49）	0.002	0.95
冠状动脉疾病或心力衰竭	23（65.71）	121（51.93）	2.59	0.10
呼吸睡眠暂停	9（25.71）	45（19.31）	6.72	0.009
高血压	9（25.71）	59（25.32）	6.72	0.009
吸烟［例（%）］			14.96	＜0.01
不吸烟	8（22.85）	55（23.60）
偶尔吸烟	20（57.14）	138（59.23）
经常吸烟	6（17.14）	40（17.16）

指标	AF		χ ²/Z值	P值
指标	+（35例）	-（233例）	χ ²/Z值	P值
性别［例（%）］			0.074	0.78
男性	22（61.76）	137（58.95）
女性	13（38.24）	96（41.05）
年龄（岁， $\bar{x}$ ±s）	63.54±8.04	46.28±4.96	12.35	＜0.001
体质量指数（kg/m²， $\bar{x}$ ±s）	27.17±4.36	27.87±4.74	0.87	0.39
民族［例（%）］			0.34	0.84
汉族	28（80.00）	182（78.11）
维吾尔族	6（17.14）	39（16.73）
其他［例（%）］	1（2.86）	12（5.16）
糖尿病	16（45.71）	106（45.49）	0.002	0.95
冠状动脉疾病或心力衰竭	23（65.71）	121（51.93）	2.59	0.10
呼吸睡眠暂停	9（25.71）	45（19.31）	6.72	0.009
高血压	9（25.71）	59（25.32）	6.72	0.009
吸烟［例（%）］			14.96	＜0.01
不吸烟	8（22.85）	55（23.60）
偶尔吸烟	20（57.14）	138（59.23）
经常吸烟	6（17.14）	40（17.16）

影响因素	Beta	OR	95%CI	P值
性别（男）	0.2248	1.2520	0.9094～1.7237	0.0768
年龄	0.1835	1.2014	1.0557～2.2013	0.0026
体质量指数	0.3708	0.6902	0.5026～0.9476	0.0019
冠状动脉疾病或心力衰竭	0.5487	1.7310	1.0739～2.7899	0.0101
呼吸睡眠暂停	0.7880	2.1989	1.5421～3.1356	0.0001
高血压	0.2090	1.2325	0.9603～1.7656	0.0544
吸烟	0.0466	1.0477	0.9763～1.6229	0.0581

因素	得分
年龄	1
体质量指数	3
冠状动脉疾病或心力衰竭	5
呼吸睡眠暂停	7
总分	16

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