CHA2DS2-VASC Score Predicts the Risk of Stroke in Patients Hospitalized to the Internal Medicine Department Without Known Atrial Fibrillation

Lahad, Karney; Maor, Elad; Klempfner, Robert; Grossman, Chagai; Druyan, Amit; Ben-Zvi, Ilan

doi:10.1007/s11606-021-07262-x

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…12 Similar demographic characteristics, including an average age of over 70 years old and a higher proportion of males, were observed in comparable investigations. 14,23 This study revealed a higher incidence of adverse clinical outcomes compared to previous studies and an increasing trend with higher CHA 2 DS 2 -VASc scores. The incidence of IS in Asian patients included in this study was notably higher across different CHA 2 DS 2 -VASc score categories compared to Western populations.…”

Section: Discussionsupporting

confidence: 46%

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Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA₂DS₂-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Fan,

Xiao,

Xue

et al. 2024

Preprint

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Background: The prognosis among non-valvular atrial fibrillation (NVAF) patients with different CHA2DS2-VASc scores in the contemporary Asian population remains unclear. Additionally, there is a lack of research examining the disparities in management patterns, healthcare resource utilization (HCRU), and cost among these patients. Therefore, this study aims to assess the incidence of clinical outcomes in NVAF patients with different CHA2DS2-VASc scores and explore their management patterns, HCRU, and cost. Methods and Results: This retrospective cohort study assessed patients diagnosed with NVAF between January 2018 and July 2022, utilizing a merged dataset from China. Patients were stratified into 3 cohorts by CHA2DS2-VASc scores: low-risk (0 for males, 1 for females), intermediate-risk (1 for males, 2 for females), and high-risk (≥2 for males, ≥3 for females). One-year incidence rates of clinical outcomes (including ischemic stroke, transient ischemic attack, arterial embolism, and major bleeding) were calculated as events per 100 person-years. Cumulative incidence and crude and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were calculated using the Fine and Gray models. Management patterns, HCRU, and cost were analyzed descriptively. Among 419,490 NVAF patients (mean age: 75.2 years, 45.1% female), 16,541 (3.9%) were classified as low-risk, 38,494 (9.2%) as intermediate-risk, and 364,455 (86.9%) as high-risk. The mean (SD) age-adjusted Charlson comorbidity index score was 4.7 (2.0), increasing with CHA2DS2-VASc scores. The one-year cumulative incidence of ischemic stroke was 3.2% (95% CI, 2.9%–3.5%) for low-risk, 4.9% (95% CI, 4.7–5.2%) for intermediate-risk (aHR, 1.3, 95% CI, 1.2–1.4), and 12.2% (95% CI, 12.1%–12.3%) for high-risk (aHR, 2.5, 95% CI, 2.3–2.8). Meanwhile, the incidence of transient ischemic attack, arterial embolism, and major bleeding showed a similar increasing trend from low-risk to high-risk. Within one year after the index date, 16.4% of patients in the low-risk cohort received oral anticoagulants (OACs), while 11.1% of patients in the high-risk cohort received OACs. The mean (SD) number of all-cause hospitalizations was 0.1 (0.1), 0.1 (0.2), and 0.1 (0.3) per-patient-per-month (PPPM) for low-risk, intermediate-risk, and high-risk, respectively. The mean (SD) length of stay increased from 0.9 (1.1) days PPPM for the low-risk to 1.2 (1.8) days PPPM for the high-risk. Conclusion: This study demonstrates that contemporary Asian NVAF patients with higher CHA2DS2-VASc scores experience higher incidence of adverse outcomes and increased hospital resource consumption. There is insufficient utilization of OACs and other AF management measures across all CHA2DS2-VASc scores groups. These findings provide new evidence for improving patient management and guiding resource allocation in healthcare.

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Section: Discussionsupporting

confidence: 46%

“…12 Similar demographic characteristics, including an average age of over 70 years old and a higher proportion of males, were observed in comparable investigations. 14,23…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA₂DS₂-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Fan,

Xiao,

Xue

et al. 2024

Preprint

View full text Add to dashboard Cite

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Clinical outcomes, management, healthcare resource utilization, and cost according to the CHA2DS2-VASc scores in Asian patients with nonvalvular atrial fibrillation

Fan,

Xiao,

Xue

et al. 2024

International Journal of Cardiology

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Advances in Prediction Model of New-Onset Atrial Fibrillation—Based on Classic Cardiovascular Risk Factors

杨

2024

ACM

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CHA2DS2-VASC Score Predicts the Risk of Stroke in Patients Hospitalized to the Internal Medicine Department Without Known Atrial Fibrillation

Cited by 3 publications

References 23 publications

Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA₂DS₂-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA₂DS₂-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Clinical outcomes, management, healthcare resource utilization, and cost according to the CHA2DS2-VASc scores in Asian patients with nonvalvular atrial fibrillation

Advances in Prediction Model of New-Onset Atrial Fibrillation—Based on Classic Cardiovascular Risk Factors

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CHA2DS2-VASC Score Predicts the Risk of Stroke in Patients Hospitalized to the Internal Medicine Department Without Known Atrial Fibrillation

Cited by 3 publications

References 23 publications

Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA2DS2-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA2DS2-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Clinical outcomes, management, healthcare resource utilization, and cost according to the CHA2DS2-VASc scores in Asian patients with nonvalvular atrial fibrillation

Advances in Prediction Model of New-Onset Atrial Fibrillation—Based on Classic Cardiovascular Risk Factors

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Product

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Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA₂DS₂-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation

Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA₂DS₂-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation