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Abstract: PO0872

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

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan
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.