Higher CHA 2 DS 2 -VASc Score Is Associated With Increased Mortality in Acute Pulmonary Embolism

• Published in: Clinical and applied thrombosis/hemostasis Vol. 23; no. 6; pp. 631 - 637
• Main 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
• Format: Journal Article
• Language: English
• Published: United States 01.09.2017
• Subjects: Acute Disease; Aged; Aged, 80 and over; Arterial Pressure; Humans; Middle Aged; Predictive Value of Tests; Pulmonary Embolism - mortality; Retrospective Studies; Risk Assessment; Severity of Illness Index; mortality; CHA2DS2-VASc score; acute pulmonary embolism
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029615627341

CHA DS -VASc score has been validated in risk prediction for stroke and thromboembolism in patients with atrial fibrillation (AF). Association of CHA DS -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 CHA DS -VASc score in patients with acute pulmonary embolism (APE). 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 CHA DS -VASc score and pulmonary embolism severity index (PESI) were calculated. 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 CHA DS -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 CHA DS -VASc score (HR: 1.67, 95% CI: 1.19-2.16, P < .01) were found to be independently correlated with mortality. The patients whose CHA DS -VASc score was between 1 and 3 had 5.67 times and patients whose CHA DS -VASc score was ≥4 had 16.8 times higher risk of mortality compared to patients with CHA DS -VASc score = 0. Patients with higher CHA DS -VASc scores had higher rates of mortality after APE.