Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 3;10(1):18942.
doi: 10.1038/s41598-020-76098-y.

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

Po-Chao Hsu  1   2 , Wen-Hsien Lee  1   2   3 , Szu-Chia Chen  4   2   3 , Yi-Chun Tsai  4   2 , Ying-Chih Chen  1   3 , Chun-Yuan Chu  1   2 , Tsung-Hsien Lin  1   2 , Wen-Chol Voon  1   2 , Wen-Ter Lai  1   2 , Sheng-Hsiung Sheu  1   2 , Ho-Ming Su  5   6   7
Affiliations

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

Po-Chao Hsu et al. Sci Rep. .

Abstract

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. CHADS2 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 CHADS2 and CHA2DS2-VASc scores for cardiovascular (CV) and all-cause mortality prediction in CKD patients. This longitudinal study enrolled 437 patients with CKD. CHADS2 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, CHADS2 and CHA2DS2-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 + CHA2DS2-VASc score had a better additive predictive value for all-cause mortality than basic model + CHADS2 score (P = 0.031). In conclusion, our study showed both of CHADS2 and CHA2DS2-VASc scores were significant predictors for long-term CV and all-cause mortality in CKD patients and CHA2DS2-VASc score had a better predictive value than CHADS2 score for all-cause mortality in direct comparison of multivariate model. Therefore, using CHADS2 and CHA2DS2-VASc scores to screen CKD patients may be helpful in identifying the high-risk group with increased mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of patient enrollment. CKD, chronic kidney disease; eGFR, estimated Glomerular filtration rate.
Figure 2
Figure 2
Nested Cox model for cardiovascular mortality (A) and all-cause mortality (B). Basic model in (A) included age, heart rate, and body mass index. Basic model in (B) included age, heart rate, body mass index, and diuretic use.
Figure 3
Figure 3
The Kaplan–Meier curves of different chronic kidney disease (CKD) stages for all-cause mortality-free survival.
See this image and copyright information in PMC

References

    1. Vlachopoulos C, et al. Association of estimated pulse wave velocity with survival: a secondary analysis of SPRINT. JAMA Netw. Open. 2019;2:e1912831. doi: 10.1001/jamanetworkopen.2019.12831. - DOI - PMC - PubMed
    1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N. Engl. J. Med. 2004;351:1296–1305. doi: 10.1056/NEJMoa041031. - DOI - PubMed
    1. Hwang SJ, Tsai JC, Chen HC. Epidemiology, impact and preventive care of chronic kidney disease in Taiwan. Nephrology (Carlton) 2010;15(Suppl 2):3–9. doi: 10.1111/j.1440-1797.2010.01304.x. - DOI - PubMed
    1. Tonelli M, et al. Chronic kidney disease and mortality risk: a systematic review. J. Am. Soc. Nephrol. 2006;17:2034–2047. doi: 10.1681/ASN.2005101085. - DOI - PubMed
    1. Whittaker CF, Miklich MA, Patel RS, Fink JC. Medication safety principles and practice in CKD. Clin. J. Am. Soc. Nephrol. 2018;13:1738–1746. doi: 10.2215/CJN.00580118. - DOI - PMC - PubMed

Publication types