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

Okubo Aiko

Doi Toshiki

Morii Kenichi

Nishizawa Yoshiko

Yamashita Kazuomi

Shigemoto Kenichiro

Mizuiri Sonoo

Usui Koji

Arita Michiko

Naito Takayuki

Masaki Takao

American Journal of Nephrology

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

Mortality

Hemodialysis

eng

Karger

© 2022 S. Karger AG, Basel. The final, published version of this article is available at https://karger.com/?doi=10.1159/000522225.

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[DOI] https://doi.org/10.1159/000522225 isVersionOf