Utility of CHA2DS2-VASc Score to Predict 1 Mid-Term Clinical Outcomes in Hemodialysis Patients

American Journal of Nephrology Volume 53 Issue 2-3 Page 169-175 published_at 2022-03-08
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Title ( eng )
Utility of CHA2DS2-VASc Score to Predict 1 Mid-Term Clinical Outcomes in Hemodialysis Patients
Okubo Aiko
Nishizawa Yoshiko
Yamashita Kazuomi
Shigemoto Kenichiro
Mizuiri Sonoo
Usui Koji
Arita Michiko
Naito Takayuki
Masaki Takao
Source Title
American Journal of Nephrology
Volume 53
Issue 2-3
Start Page 169
End Page 175
Background. The CHA2DS2-VASc score has been widely used to predict stroke in patients with atrial fibrillation (AF). Recently, it was reported that the CHA2DS2-VASc score helps predict cardiovascular disease (CVD) or all-cause mortality in patients with or without AF. However, few reports have examined the association between this score and mortality in hemodialysis patients.
Methods. We analyzed 557 consecutive patients who initiated hemodialysis at our facilities between February 2005 and October 2017. The CHA2DS2-VASc score was calculated at the time of initiation of hemodialysis. Patients were then categorized into three groups according to their CHA2DS2-VASc scores: 0–1 (low), 2–3 (intermediate), and 4–9 (high). Multivariate Cox proportional hazards analysis was used to assess independent risk factors for 3-year all-cause mortality.
Results. During the 3-year follow-up period, 153 (27.5%) patients died (cardiovascular death: n=88). According to multivariate analysis, serum albumin (hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.43–0.85, P=0.003), creatinine (HR 0.91, 95% CI 0.84–0.99, P=0.049), and CHA2DS2-VASc score (HR 1.33, 95% CI 1.20–1.46, P<0.001) were associated with 3-year all-cause mortality. Compared with patients in the low CHA2DS2-VASc score group, those in the intermediate and high score groups had a higher risk for all-cause and CVD mortality (all-cause mortality: 50 HR 1.77, 95% CI 1.23–2.55, P=0.002 and HR 2.94, 95% CI 1.90–4.53, P<0.001, respectively; CVD mortality: HR 1.82, 95% CI 1.27–2.59, P=0.001 and HR 2.85, 95% CI 1.88–4.31, P<0.001, respectively).
Conclusion. The CHA2DS2-VASc score is a valuable predictor of 3-year all-cause and CVD mortality in incident hemodialysis patients.
CHA2DS2-VASc score
Resource Type journal article
Date of Issued 2022-03-08
© 2022 S. Karger AG, Basel. The final, published version of this article is available at https://karger.com/?doi=10.1159/000522225.
This is not the published version. Please cite only the published version.
Publish Type Accepted Manuscript
Access Rights open access
Source Identifier
[DOI] https://doi.org/10.1159/000522225 isVersionOf