Development of risk prediction model for new-onset atrial fibrillation in elderly patients undergoing video-assisted thoracoscopic surgery: a retrospective cohort study

Background: Postoperative atrial fibrillation (POAF) is among the most frequent complications after video-assisted thoracoscopic surgery (VATS). Although there are numerous risk prediction models and advanced age is a notable factor, only a handful of these models specifically address older, high-risk groups. This study therefore aimed to construct a POAF risk model for patients aged 65 years and older undergoing VATS to support precise perioperative monitoring and preventive measures. Methods: We conducted a retrospective analysis of 4,449 eligible patients aged ≥65 years who underwent VATS at Peking Union Medical College Hospital from January 2013 to March 2024. The data were split into a training cohort (n=2,918) and a testing cohort (n=1,531) using a cutoff date of January 1, 2022. POAF was defined as follows: (I) any recorded atrial fibrillation episode lasting at least 6 minutes; (II) no history of atrial fibrillation (AF) prior to surgery; and (III) onset within 30 days postoperatively. Variables with a univariable P