{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:52Z","timestamp":1792787272871,"version":"4.5.0"},"reference-count":43,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Institute of Health","award":["R01HL149998"],"award-info":[{"award-number":["R01HL149998"]}]},{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["NIHR131227"],"award-info":[{"award-number":["NIHR131227"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,2]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"\n Objectives<\/jats:title>\n \n This study was undertaken to identify potential predictors of atrial fibrillation after cardiac surgery (AFACS) through a modified Delphi process and expert consensus. These will supplement predictors identified through a systematic review and cohort study to inform the development of two AFACS prediction models as part of the PARADISE project (\n NCT05255224<\/jats:ext-link>\n ). Atrial fibrillation is a common complication after cardiac surgery. It is associated with worse postoperative outcomes. Reliable prediction of AFACS would enable risk stratification and targeted prevention. Systematic identification of candidate predictors is important to improve validity of AFACS prediction tools.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This study is a Delphi consensus exercise.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n This study was undertaken through remote participation.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n The participants are an international multidisciplinary panel of experts selected through national research networks.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n This is a two-stage consensus exercise consisting of generating a long list of variables, followed by refinement by voting and retaining variables selected by at least 40% of panel members.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The panel comprised 15 experts who participated in both stages, comprising cardiac intensive care physicians (n=3), cardiac anaesthetists (n=2), cardiac surgeons (n=1), cardiologists (n=4), cardiac pharmacists (n=1), critical care nurses (n=1), cardiac nurses (n=1) and patient representatives (n=2). Our Delphi process highlighted candidate AFACS predictors, including both patient factors and those related to the surgical intervention. We generated a final list of 72 candidate predictors. The final list comprised 3 demographic, 29 comorbidity, 4 vital sign, 13 intraoperative, 10 postoperative investigation and 13 postoperative intervention predictors.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A Delphi consensus exercise has the potential to highlight predictors beyond the scope of existing literature. This method proved effective in identifying a range of candidate AFACS predictors. Our findings will inform the development of future AFACS prediction tools as part of the larger PARADISE project.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT05255224<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086589","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T22:50:49Z","timestamp":1727304649000},"page":"e086589","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Atrial fibrillation after cardiac surgery: identifying candidate predictors through a Delphi process"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05255224","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05255224","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05255224","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05255224","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9455-022X","authenticated-orcid":false,"given":"Jonathan","family":"Bedford","sequence":"first","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"},{"name":"Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara G","family":"Fields","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2772-2316","authenticated-orcid":false,"given":"Gary Stephen","family":"Collins","sequence":"additional","affiliation":[{"name":"Centre for Statistics in Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, Merseyside, UK"},{"name":"Department of Clinical Medicine, Aalborg University, Aalborg, Region Nordjylland, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Clifton","sequence":"additional","affiliation":[{"name":"Department of Engineering Science, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Department of Perioperative Medicine, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen D","family":"Muehlschlegel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-3927","authenticated-orcid":false,"given":"Peter J","family":"Watkinson","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"},{"name":"Oxford University Hospitals NHS Foundation Trust, Oxford, 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