CHA2DS2-VASc预测了冠状动脉旁路移植患者的再入院,结果和资源利用情况:一项为期7年的国家再入院数据库研究
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
概括
在CHA2DS2-VASc得分有效预测不良结果,包括更高的再入院率,更长的住院时间,以及增加的医疗保健费用,对于接受冠状动脉旁路移植的患者,不论心房的状态.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- CHA2DS2-VASc评分是评估心房动 (AF) /心房动 (AFL) 中血栓栓塞风险的标准.
- 在患有或没有AF/AFL的患者中,它对冠状动脉旁路移植 (CABG) 后结局和再入院的预测效益还未得到充分研究.
研究的目的:
- 评估CHA2DS2-VASc得分在预测结果,住院时间 (LOS) 和CABG后医疗相关成本 (HAC) 的有效性.
- 评估得分的预测能力是否延伸到没有AF/AFL史的患者.
主要方法:
- 从2010年至2017年使用了国家再录取数据库 (NRD),包括接受CABG的患者,无论是否有AF/AFL.
- 使用多重回归和Cox-Hazard分析来评估高达90天再接收,LOS和HAC的结果,与CHA2DS2-VASc评分 (截止分数为6) 相比.
主要成果:
- 在420,458名CABG患者中,18.3%在90天内重新入院.
- 较高的CHA2DS2-VASc得分与90天再入院 (包括TIA/中风和心力衰竭) 的增加以及生存率的降低相关 (p<0.0001).
- 在AF/AFL和非AF/AFL组中,增加得分与更长的LOS和更高的HAC (p<0.001) 有关.
结论:
- CHA2DS2-VASc评分是一个有价值的,简单的工具,用于预测CABG后不良结果,再录取,LOS和HAC.
- 它的预测效用在患有和没有AF/AFL的患者中得到证明,这突出了其更广泛的适用性.
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