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CHA2DS2-VASc predicts readmission, outcomes and resource utilization in patients undergoing coronary artery bypass

Syed Emir Irfan Wafa1, Hiroyuki Sawatari2, Raheel Ahmed3

  • 1Department of Cardiology, Russell's Hall Hospital, Dudley Group NHS Foundation Trust, UK.

International Journal of Cardiology
|September 7, 2024
PubMed

Insights

The CHA2DS2-VASc score effectively predicts adverse outcomes, including higher readmission rates, longer hospital stays, and increased healthcare costs, for patients undergoing coronary artery bypass grafting, irrespective of atrial fibrillation status.

Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • The CHA2DS2-VASc score is standard for assessing thromboembolic risk in atrial fibrillation (AF)/atrial flutter (AFL).
  • Its predictive utility for outcomes and readmissions post-coronary artery bypass grafting (CABG) in patients with or without AF/AFL is understudied.

Purpose of the Study:

  • To evaluate the CHA2DS2-VASc score's effectiveness in predicting outcomes, length of hospital stay (LOS), and healthcare-associated costs (HAC) after CABG.
  • To assess if the score's predictive power extends to patients without a history of AF/AFL.

Main Methods:

  • Utilized the National Readmission Database (NRD) from 2010-2017, including patients undergoing CABG with or without AF/AFL.
  • Employed multiple regression and Cox-Hazard analyses to assess outcomes up to 90-day readmission, LOS, and HAC against the CHA2DS2-VASc score (cut-off score of 6).

Main Results:

  • Of 420,458 CABG patients, 18.3% were readmitted within 90 days.
  • Higher CHA2DS2-VASc scores correlated with increased 90-day readmissions (including for TIA/Stroke and heart failure) and decreased survival rates (p<0.0001).
  • Increasing scores were associated with longer LOS and higher HAC (p<0.001) in both AF/AFL and non-AF/AFL groups.

Conclusions:

  • The CHA2DS2-VASc score is a valuable, simple tool for predicting adverse outcomes, readmissions, LOS, and HAC after CABG.
  • Its predictive utility is demonstrated in patients with and without AF/AFL, highlighting its broader applicability.
Abstract

Keywords:
Atrial fibrillationCHA(2)DS(2)-VASc scoreCardiac arrhythmiaCoronary-artery bypass graftingHospitalization

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