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CHA2DS2-VASc Is Associated With In-Hospital Mortality in Patients With Infective Endocarditis: A Cross-Sectional
Temidayo Abe1, Gabrielle De Allie1, Harry O Eyituoyo2
1Internal Medicine, Morehouse School of Medicine, Atlanta, USA.
Insights
The CHA2DS2-VASc score, used for atrial fibrillation (AF) stroke risk, effectively predicts mortality in infective endocarditis (IE) patients. Higher scores correlate with increased in-hospital death risk in IE cases.
Area of Science:
- Cardiology
- Infectious Diseases
- Clinical Risk Stratification
Background:
- The CHA2DS2-VASc score is a standard tool for assessing stroke risk in atrial fibrillation (AF) patients.
- Clinical variables within the CHA2DS2-VASc score are linked to adverse outcomes in infective endocarditis (IE).
Purpose of the Study:
- To evaluate the utility of the CHA2DS2-VASc score in predicting clinical outcomes for patients diagnosed with infective endocarditis.
Main Methods:
- Analysis of 35,570 IE patients from the National Inpatient Sample (NIS) database (2009-2012).
- Calculation of CHA2DS2-VASc scores for all included patients.
- Hierarchical logistic regression to determine adjusted odds ratios for in-hospital mortality across different CHA2DS2-VASc scores (0-9).
Main Results:
- Higher CHA2DS2-VASc scores were significantly associated with increased in-hospital mortality in IE patients.
- The CHA2DS2-VASc score distribution ranged from 0 (8.1%) to 8 (21.7%) within the study cohort.
- Adjusted analysis confirmed that increasing CHA2DS2-VASc scores correlated with elevated odds of overall mortality.
Conclusions:
- The CHA2DS2-VASc score demonstrates potential as a valuable risk assessment tool for predicting outcomes in patients with infective endocarditis.
- Further research is warranted to validate these findings and establish the score's role in IE management.
Abstract:
Background and objective The CHA2DS2-VASc score is a stroke risk stratification tool that is used in patients with atrial fibrillation (AF). Most of its clinical variables have been associated with poor outcomes in patients with infective endocarditis (IE). In this study, we aimed to determine its utility in predicting outcomes in IE patients. Methods We included 35,570 patients with IE from the National Inpatient Sample (NIS), 2009-2012. The CHA2DS2-VASc score was calculated for each patient. Hierarchical logistic regression was used to estimate the adjusted odds ratio for in-hospital mortality for CHA2DS2-VASc scores from 1 to 9, using a score of 0 as the reference score. All clinical characteristics were defined using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Results The mean age of the sample was 57.81 ±14 years. Higher CHA2DS2-VASc scores were associated with increased mortality, and the scores among the sample ranged from 0 for 8.1% to 8 for 21.7%. In the hierarchical logistic regression, after adjusting for age, sex, and relevant comorbidities, as the score increased, so did the odds for overall mortality. Conclusion In patients with IE, the CHA2DS2-VASc score may serve as a risk assessment tool with which to predict outcomes. Further studies are needed to replicate these findings.
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Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...

