CHA2DS2-VASc score as a predictor of clinical outcomes in hospitalized patients with and without chronic kidney disease
© 2023. The Author(s)..
BACKGROUND: High CHA2DS2-VASc score (Congestive heart failure, Hypertension, Age > 75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65-74 and Sex category) was associated with adverse clinical outcomes in different settings. The aim of the present study was to evaluate the association between CHA2DS2-VASc score and R2CHA2DS2-VASc score (which includes renal impairment) with in-hospital mortality and length of hospital stay in patients hospitalized in an internal medicine ward.
METHODS: We enrolled 983 consecutive patients admitted during 3 years in an internal medicine ward. R2CHA2DS2-VASc score was calculated by adding 2 points to CHA2DS2-VASc for the presence of chronic kidney disease (CKD), defined according to K-DOQI. The primary outcome was a composite of all-cause mortality and length of hospital stay > 10 days.
RESULTS: Patients with CKD stages 3-5 presented with increased CHA2DS2-VASc vs stages 1-2 (p < 0.001). The composite outcome occurred in 47.3% of inpatients. Multivariable linear logistic regression analyses adjusted for presence of infectious diseases and cancer, with the occurrence of composite outcome showed an adjusted OR of 1.349 (95% CI 1.248-1.462) and 1.254 (95% CI 1.179-1.336) for CHA2DS2-VASc and R2CHA2DS2-VASc scores, respectively. No differences were found in the association between CHA2DS2-VASc and R2CHA2DS2-VASc scores with the composite outcome (AUC 0.631 vs 0.630), and furthermore, adding the presence/absence of infectious diseases during hospitalization and positive cancer history to the models increased the AUC (0.667 and 0.663).
CONCLUSIONS: Incrementally higher CHA2DS2-VASc score is associated with increased length of hospital stay and mortality in patients hospitalized in an internal medicine ward, regardless of the presence of CKD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Journal of nephrology - 37(2024), 2 vom: 28. März, Seite 409-417 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gigante, Antonietta [VerfasserIn] |
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| Links: |
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| Themen: |
CHA2DS2-VASc score |
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| Anmerkungen: |
Date Completed 25.04.2024 Date Revised 27.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s40620-023-01805-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364302887 |
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| 100 | 1 | |a Gigante, Antonietta |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a CHA2DS2-VASc score as a predictor of clinical outcomes in hospitalized patients with and without chronic kidney disease |
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| 500 | |a Date Revised 27.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: High CHA2DS2-VASc score (Congestive heart failure, Hypertension, Age > 75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65-74 and Sex category) was associated with adverse clinical outcomes in different settings. The aim of the present study was to evaluate the association between CHA2DS2-VASc score and R2CHA2DS2-VASc score (which includes renal impairment) with in-hospital mortality and length of hospital stay in patients hospitalized in an internal medicine ward | ||
| 520 | |a METHODS: We enrolled 983 consecutive patients admitted during 3 years in an internal medicine ward. R2CHA2DS2-VASc score was calculated by adding 2 points to CHA2DS2-VASc for the presence of chronic kidney disease (CKD), defined according to K-DOQI. The primary outcome was a composite of all-cause mortality and length of hospital stay > 10 days | ||
| 520 | |a RESULTS: Patients with CKD stages 3-5 presented with increased CHA2DS2-VASc vs stages 1-2 (p < 0.001). The composite outcome occurred in 47.3% of inpatients. Multivariable linear logistic regression analyses adjusted for presence of infectious diseases and cancer, with the occurrence of composite outcome showed an adjusted OR of 1.349 (95% CI 1.248-1.462) and 1.254 (95% CI 1.179-1.336) for CHA2DS2-VASc and R2CHA2DS2-VASc scores, respectively. No differences were found in the association between CHA2DS2-VASc and R2CHA2DS2-VASc scores with the composite outcome (AUC 0.631 vs 0.630), and furthermore, adding the presence/absence of infectious diseases during hospitalization and positive cancer history to the models increased the AUC (0.667 and 0.663) | ||
| 520 | |a CONCLUSIONS: Incrementally higher CHA2DS2-VASc score is associated with increased length of hospital stay and mortality in patients hospitalized in an internal medicine ward, regardless of the presence of CKD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CHA2DS2-VASc score | |
| 650 | 4 | |a Chronic kidney disease | |
| 650 | 4 | |a Internal medicine, mortality, length of stay | |
| 700 | 1 | |a Imbimbo, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Andreini, Martina |e verfasserin |4 aut | |
| 700 | 1 | |a Proietti, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Palladino, Mariangela |e verfasserin |4 aut | |
| 700 | 1 | |a Molfino, Alessio |e verfasserin |4 aut | |
| 700 | 1 | |a Alunni Fegatelli, Danilo |e verfasserin |4 aut | |
| 700 | 1 | |a Muscaritoli, Maurizio |e verfasserin |4 aut | |
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