Performance of the CHA 2 DS 2 -VASc score in predicting new onset atrial fibrillation during hospitalization for community-acquired pneumonia
| Autor: | Elisa Antonielli, Giulia De Marzi, Beatrice Biondo, Filippo Pieralli, Lucia Maddaluni, Carlotta Casati, Marco Falcone, Iacopo Olivotto, Carlo Nozzoli, Vieri Vannucchi |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Community-acquired pneumonia Population 030204 cardiovascular system & hematology VASc score (MeSH terms): Atrial fibrillation CHA 2 DS 03 medical and health sciences 0302 clinical medicine Internal medicine Internal Medicine Medicine Sinus rhythm In patient 030212 general & internal medicine education education.field_of_study business.industry medicine.disease New onset atrial fibrillation Pneumonia CHA2DS2–VASc score business Complication |
| Popis: | Background Cardiovascular events are common during hospitalization for community-acquired pneumonia (CAP), with new onset atrial fibrillation (NOAF) being the second most relevant complication. In this study, we aimed to investigate the role of CHA2DS2-VASc score in predicting NOAF during hospitalization for CAP. Methods Patients admitted for CAP were prospectively assessed using CHA2DS2-VASc. The end-point of the study was the occurrence of any objectively documented episode of NOAF during hospitalization in patients that were in sinus rhythm at hospital admission. Results Of 468 patients enrolled (median age 76 years), 48 (10.3%) experienced NOAF during hospitalization. They were older, had more comorbidities, more severe pneumonia, and higher CHA2DS2-VASc than those who remained in sinus rhythm (4.4 ± 1.6 vs 3.4 ± 1.9, respectively; p 3 was the most accurate cut-off for prediction of NOAF (AUC 0.653; 95% CI 0.577–0.729; p = .001). In two different multivariable models, each CHA2DS2-VASc point increase and a score > 3 both were independently associated with NOAF (HR 1.3; 95% CI 1.09–1.55; p = .003 and 2.3; 95% CI 1.19–4.44; p = .007, respectively). Conclusions CHA2DS2-VASc score is an accurate and independent predictor of NOAF in patients with CAP, and a score > 3 features a population at high risk of developing the arrhythmia during hospitalization. This simple and effective tool should be incorporated in the evaluation of patients hospitalized for CAP, with implications ranging from arrhythmic prevention to anticoagulation management. |
| Databáze: | OpenAIRE |
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