Using CHADS2 and CHA2DS2-VASc scores for mortality prediction in patients with chronic kidney disease

• Published in: Scientific reports Vol. 10; no. 1; p. 18942
• Main Authors: Hsu, Po-Chao, Lee, Wen-Hsien, Chen, Szu-Chia, Tsai, Yi-Chun, Chen, Ying-Chih, Chu, Chun-Yuan, Lin, Tsung-Hsien, Voon, Wen-Chol, Lai, Wen-Ter, Sheu, Sheng-Hsiung, Su, Ho-Ming
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03-11-2020; Nature Publishing Group
• Subjects: 692/4022/1585; 692/53/2422; 692/53/2423; 692/699/1585; Cardiovascular diseases; Fibrillation; Heart rate; Humanities and Social Sciences; Kidney diseases; Morbidity; Mortality; multidisciplinary; Multivariate analysis; Predictions; Public health; Risk groups; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-76098-y

Chronic kidney disease (CKD) is a public health issue and is associated with high morbidity and mortality. How to identify the high-risk CKD patients is very important to improve the long-term outcome. CHADS
2
and CHA2DS2-VASc scores are clinically useful scores to evaluate the risk of stroke in patients with atrial fibrillation. However, there was no literature discussing about the usefulness of CHADS
2
and CHA2DS2-VASc scores for cardiovascular (CV) and all-cause mortality prediction in CKD patients. This longitudinal study enrolled 437 patients with CKD. CHADS
2
and CHA2DS2-VASc scores were calculated for each patient. CV and all-cause mortality data were collected for long-term outcome prediction. The median follow-up to mortality was 91 (25th–75th percentile: 59–101) months. There were 66 CV mortality and 165 all-cause mortality. In addition to age and heart rate, CHADS
2
and CHA
2
DS
2
-VASc scores (both
P
value < 0.001) were significant predictors of CV and all-cause mortality in the multivariate analysis. Besides, in direct comparison of multivariate model, basic model + CHA
2
DS
2
-VASc score had a better additive predictive value for all-cause mortality than basic model + CHADS
2
score (
P
 = 0.031). In conclusion, our study showed both of CHADS
2
and CHA
2
DS
2
-VASc scores were significant predictors for long-term CV and all-cause mortality in CKD patients and CHA
2
DS
2
-VASc score had a better predictive value than CHADS
2
score for all-cause mortality in direct comparison of multivariate model. Therefore, using CHADS
2
and CHA
2
DS
2
-VASc scores to screen CKD patients may be helpful in identifying the high-risk group with increased mortality.