Key result
HATCH score predicts new-onset AF with a moderate 0.60 C-index in elderly patients.
Why the study?
Assessing individual risk of new-onset atrial fibrillation (NOAF) is pivotal for primary prevention in aging populations, but the predictive role of the HATCH score in elderly hospital-based Chinese patients had never been evaluated.
Does the HATCH score predict new-onset atrial fibrillation in elderly hospital-based Chinese patients?
Cohort (n=7,718)
No
Does the HATCH score predict new-onset atrial fibrillation in elderly hospital-based Chinese patients?
Effect estimate: C-index 0.60 (95% CI 0.57-0.63)
The HATCH score demonstrates moderate predictive value for identifying new-onset atrial fibrillation in elderly Chinese hospital patients, which may aid in primary prevention efforts.
May aid NOAF risk stratification in elderly Chinese inpatients; leaves open prospective validation before clinical use.
BACKGROUND: The aging population represents high risk in developing new-onset atrial fibrillation (NOAF). Assessing individual risk of NOAF is pivotal for primary prevention. The role of the HATCH score for predicting NOAF in the elderly hospital-based Chinese population has never been evaluated.METHODS: In our center, the development of NOAF was followed among patients aged over 65 years. Incidence of NOAF was calculated. Risk factors for NOAF were investigated using uni- and multivariable Cox regression analysis. The performance of the HATCH score for predicting NOAF was evaluated using Kaplan-Meier curve analysis with DeLong test and C-indexes.RESULTS: A total of 7718 elderly patients were enrolled in the present study, with 421 developed NOAF during 3.18 ± 3.73 years of follow-up with an incidence of 1.71 (95%CI 1.55-1.89) per 100 patient-years. After adjusted with cofounders, only hypertension (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.23-1.85), COPD (HR 1.86, 95%CI 1.22-2.84) and HF (HR 1.82, 95%CI 1.28-2.59) were independently related to NOAF. The risk of NOAF increased with a higher HATCH score (38% higher risk per 1-point increase). Among those with a HATCH score ≥4, the risk of NOAF was 4.01 (95%CI 3.85-4.16) per 100 patient-years (Log-rank P <0.001). The C-index for the HATCH score was moderate (0.60 [95%CI, 0.57-0.63]), which was better than the single criteria but comparative to other scoring systems.CONCLUSION: In this elderly hospital-based Chinese population, the HATCH score had a moderate predictive ability for NOAF.
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Wu et al. (2021) conducted a cohort in New-onset atrial fibrillation (n=7,718). HATCH score vs. Single risk criteria (age, COPD, hypertension, heart failure) was evaluated on New-onset atrial fibrillation (C-index 0.60, 95% CI 0.57-0.63). In an elderly hospital-based Chinese population, the HATCH score demonstrated a moderate predictive ability for new-onset atrial fibrillation with a C-index of 0.60.
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