Key result
CHA2DS2-VASc score of 8 linked to ~222% higher in-hospital mortality versus 0 in infective endocarditis.
Why the study?
Most clinical variables in the CHA2DS2-VASc score are associated with poor outcomes in infective endocarditis, prompting evaluation of its utility in predicting IE outcomes.
Is a higher CHA2DS2-VASc score associated with increased in-hospital mortality in patients with infective endocarditis?
Cross-Sectional (n=35,570)
Yes
Is a higher CHA2DS2-VASc score associated with increased in-hospital mortality in patients with infective endocarditis?
Effect estimate: OR 3.22 (95% CI 1.185-8.733)
Absolute Event Rate: 21.7% vs 8.1%
p-value: p=0.022
The CHA2DS2-VASc score, traditionally used for stroke risk in atrial fibrillation, may also serve as a useful risk assessment tool to predict in-hospital mortality in patients with infective endocarditis.
May support CHA2DS2-VASc for mortality risk stratification in infective endocarditis; leaves open clinical utility pending prospective validation.
Background and objective The CHA2DS2-VASc score is a stroke risk stratification tool that is used in patients with atrial fibrillation (AF). Most of its clinical variables have been associated with poor outcomes in patients with infective endocarditis (IE). In this study, we aimed to determine its utility in predicting outcomes in IE patients. Methods We included 35,570 patients with IE from the National Inpatient Sample (NIS), 2009-2012. The CHA2DS2-VASc score was calculated for each patient. Hierarchical logistic regression was used to estimate the adjusted odds ratio for in-hospital mortality for CHA2DS2-VASc scores from 1 to 9, using a score of 0 as the reference score. All clinical characteristics were defined using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Results The mean age of the sample was 57.81 ±14 years. Higher CHA2DS2-VASc scores were associated with increased mortality, and the scores among the sample ranged from 0 for 8.1% to 8 for 21.7%. In the hierarchical logistic regression, after adjusting for age, sex, and relevant comorbidities, as the score increased, so did the odds for overall mortality. Conclusion In patients with IE, the CHA2DS2-VASc score may serve as a risk assessment tool with which to predict outcomes. Further studies are needed to replicate these findings.
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Abe et al. (2020) conducted a cross-sectional in Infective endocarditis (n=35,570). CHA2DS2-VASc score vs. CHA2DS2-VASc score of 0 was evaluated on All-cause in-hospital mortality (OR 3.22, 95% CI 1.185-8.733, p=0.022). In patients with infective endocarditis, a CHA2DS2-VASc score of 8 was associated with significantly increased in-hospital mortality compared to a score of 0 (OR 3.22).
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