Higher CHA2DS2-VASc Score Is Associated With Increased Mortality in Acute Pulmonary Embolism. (September 2017)

• Record Type: Journal Article
• Authors: Onuk, Tolga; Karataş, Mehmet Baran; İpek, Göktürk; Güngör, Barış; Akyüz, Şükrü; Çanga, Yiğit; Uzun, Ahmet Okan; Avcı, İlhan İlker; Ösken, Altuğ; Kaşıkçıoğlu, Hülya; Çam, Neşe
• Is Part Of: Clinical and applied thrombosis/hemostasis. Volume 23:Number 6(2017)
• Page Start: 631
• Page End: 637
• Publication Date: 2017-09
• Subjects: acute pulmonary embolism -- CHA2DS2-VASc score -- mortality; Hemostasis -- Periodicals; Thrombosis -- Periodicals; 616.13
• DOI: 10.1177/1076029615627341
• Languages: English
• ISSNs: 1076-0296

Abstract

Background: CHA2 DS2 -VASc score has been validated in risk prediction for stroke and thromboembolism in patients with atrial fibrillation (AF). Association of CHA2 DS2 -VASc score with higher risk of venous thromboembolism and pulmonary embolism (PE) has also been shown. In this study, we investigated the long-term prognostic value of CHA2 DS2 -VASc score in patients with acute pulmonary embolism (APE). Methods: Consecutive patients with APE presenting to our emergency department were retrospectively recruited. Patients with AF and who died secondary to causes other than PE were excluded from the study. The CHA2 DS2 -VASc score and pulmonary embolism severity index (PESI) were calculated. Results: Two hundred seventy seven participants were included in the study. The mortality rate was 18.7%. Twenty-two cases died within 30 days, and 30 cases died during the follow-up period (median: 13 months). The mean CHA2 DS2 -VASc score was significantly higher in dead patients compared to survivors (3.61 ± 1.35 vs 1.95 ± 1.52, P < .01). In multivariate regression analysis, systolic pulmonary artery pressure (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.01-1.06, P = .02), PESI score (HR: 1.010, 95% CI: 1.004-1.017, P < .01), and CHA2 DS2 -VASc score (HR: 1.67, 95% CI: 1.19-2.16, P < .01) were found to be independently correlated with mortality. The patients whose CHA2 DS2 -VASc score was between 1 and 3 had 5.67 times and patients whose CHA2 DS2 -VASc score was ≥4 had 16.8 times higher risk of mortality compared to patients with CHA2 DS2 -VASc score = 0. Conclusion: Patients with higher CHA2 DS2 -VASc scores had higher rates of mortality after APE.