Kidney Week

Abstract: PO0872

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

Session Information

• Fluid, Electrolytes, and Clinical Events with Dialysis: Getting to the "Heart" of the Matter
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Aiko Okubo, MD, PhD

• Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Toshiki Doi,

• Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Yoshiko Nishizawa,

• Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Kenichiro Shigemoto,

• Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Sonoo Mizuiri,

• Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan

Takao Masaki,

Background

The CHA₂DS₂-VASc score has been widely used as a predictive score for stroke in patients with atrial fibrillation (AF). Recently, it was reported that the CHA₂DS₂-VASc score is useful for predicting 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 525 consecutive patients who started hemodialysis at our facilities from March 2006 to October 2017. CHA₂DS₂-VASc score was calculated at time of initiation of hemodialysis. 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 (29.1%) patients died (cardiovascular death, n=88). According to multivariate analysis, serum albumin [hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.43–0.89, P=0.01], creatinine (HR 0.81, 95% CI 0.71–0.99, P=0.03), and CHA₂DS₂-VASc score (HR 1.33, 95% CI 1.21–1.46, P<0.001) were associated with 3-year all-cause mortality. Patients with CHA₂DS₂-VASc score ≥4 had higher risk of all-cause and CVD mortality than those with CHA₂DS₂-VASc score <4 (all-cause mortality: HR 2.20, 95% CI 1.42–3.71, P<0.001; CVD mortality: HR 2.83, 95% CI 1.37–5.44, P<0.001).

Conclusion

The CHA₂DS₂-VASc score is a useful predictor of 3-year all-cause and CVD mortality in incident hemodialysis patients.