TY - JOUR
T1 - CHA2DS2-VASc and readmission with new-onset atrial fibrillation, atrial flutter, or acute cerebrovascular accident
AU - Rutland, Joshua
AU - Ayoub, Karam
AU - Etaee, Farshid
AU - Ogunbayo, Gbolahan
AU - Darrat, Yousef
AU - Marji, Meera
AU - Masri, Ahmad
AU - Elayi, Claude S.
N1 - Publisher Copyright:
© 2020
PY - 2021/1/15
Y1 - 2021/1/15
N2 - Background: Although risk factors for atrial fibrillation (AF) and atrial flutter (AFL) are known, identifying patients who will develop AF/AFL within the near future remains challenging. We sought to evaluate if the CHA2DS2-VASc risk score (CVRS) can identify hospital readmissions with AF, AFL, or acute cerebrovascular accident (CVA) among hospitalized patients without prior history of AF/AFL. Methods: Using the Nationwide Readmission Database, a study cohort included patients without prior AF/AFL or new diagnosis of AF/AFL at the index hospitalization from 2012 to 2014. Patients were stratified based on the CVRS into three groups: Low (CVRS ≤1), Intermediate (CVRS 2–5), and High (CVRS ≥6).The primary outcome of interest was 180-day readmission rate with a primary or secondary diagnosis of AF/AFL. Secondary outcomes of interest were acute CVA and 6-month mortality rate. Results: A total of 17,820,640 patients were included in our study. Over a 6-month follow up duration from the index hospitalization, the overall re-admission rate for new onset atrial arrhythmias (AF/AFL) was 3.48% (n = 620,986), acute CVA 0.13% (n = 22,522), and all-cause mortality 0.31% (n = 55,632). When compared to other groups, patients with a higher CVRS were readmitted more frequently for AF/AFL [odds ratio (OR) 2.43; 95% confidence interval (CI) 2.41–2.45, P < .0001), acute CVA (OR 3.96; 95%CI 3.85–4.08, P < .0001), and all-cause mortality (OR 2.19; 95%CI 2.14–2.24, P < .0001). Conclusion: In this large contemporary cohort, a CHADS2VA2SC score ≥ 6 identified patients without known prior atrial arrhythmias at an elevated risk of developing AF/AFL or acute CVA within 6 months of hospitalization.
AB - Background: Although risk factors for atrial fibrillation (AF) and atrial flutter (AFL) are known, identifying patients who will develop AF/AFL within the near future remains challenging. We sought to evaluate if the CHA2DS2-VASc risk score (CVRS) can identify hospital readmissions with AF, AFL, or acute cerebrovascular accident (CVA) among hospitalized patients without prior history of AF/AFL. Methods: Using the Nationwide Readmission Database, a study cohort included patients without prior AF/AFL or new diagnosis of AF/AFL at the index hospitalization from 2012 to 2014. Patients were stratified based on the CVRS into three groups: Low (CVRS ≤1), Intermediate (CVRS 2–5), and High (CVRS ≥6).The primary outcome of interest was 180-day readmission rate with a primary or secondary diagnosis of AF/AFL. Secondary outcomes of interest were acute CVA and 6-month mortality rate. Results: A total of 17,820,640 patients were included in our study. Over a 6-month follow up duration from the index hospitalization, the overall re-admission rate for new onset atrial arrhythmias (AF/AFL) was 3.48% (n = 620,986), acute CVA 0.13% (n = 22,522), and all-cause mortality 0.31% (n = 55,632). When compared to other groups, patients with a higher CVRS were readmitted more frequently for AF/AFL [odds ratio (OR) 2.43; 95% confidence interval (CI) 2.41–2.45, P < .0001), acute CVA (OR 3.96; 95%CI 3.85–4.08, P < .0001), and all-cause mortality (OR 2.19; 95%CI 2.14–2.24, P < .0001). Conclusion: In this large contemporary cohort, a CHADS2VA2SC score ≥ 6 identified patients without known prior atrial arrhythmias at an elevated risk of developing AF/AFL or acute CVA within 6 months of hospitalization.
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U2 - 10.1016/j.ijcard.2020.08.027
DO - 10.1016/j.ijcard.2020.08.027
M3 - Article
C2 - 32800906
AN - SCOPUS:85089706496
SN - 0167-5273
VL - 323
SP - 72
EP - 76
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -