Nephron · 2025
CHA2DS2-VASc Score as a Predictor of Cardiovascular and All-Cause Mortality in a Prospective Cohort of Hemodialysis Patients of Predominantly African Ancestry: The PROHEMO.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gutiérrez-Peredo Gabriel Brayan, Gutiérrez-Peredo Andrea Jimena, Montaño-Castellón Iris, Marques da Silva Neto Marinho, Albuquerque da Silva Fernanda, Silva Martins Marcia Tereza, Mendes Matos Cacia, Correia Monteiro Jean Michell, Guimarães Silva Pedro, Lopes Gildete Barreto, Barreto Lopes Marcelo, Correia Luis Claudio, Pecoits-Filho Roberto, Norris Keith C, Lopes Antonio Alberto
Аннотация
UNLABELLED: <p>Background: Patients with chronic kidney disease undergoing maintenance hemodialysis (MHD) have an increased mortality. The CHA2DS2-VASc score, initially used for stroke prediction in atrial fibrillation, is relevant for various cardiovascular conditions. This study evaluates its effectiveness in predicting cardiovascular and all-cause mortality in MHD patients.
METHODS: Data are from the "Prospective Study of the Prognosis of Patients on Chronic Hemodialysis" (PROHEMO) in Salvador, Brazil. Patients were divided by CHA2DS2-VASc scores: ≤2 and >2. Cox regression estimated hazard ratios (HR) for death, both unadjusted and adjusted for confounders. We assessed the distribution of each score variable and its association with mortality. A modified CHA2DS2-VASc score was created due to the low percentage of patients over 75 (1.3%) and normotensive (4.6%).
RESULTS: A total of 237 patients (mean age 51.6 years; 57.0% male) were included in the study. There were 55 deaths, 21 from cardiovascular causes. For patients with a CHA2DS2-VASc score >2, the unadjusted hazard of all-cause mortality was doubled (HR = 2.05; 95% CI: 1.20, 3.49) compared to those with a score ≤2, and the risk for cardiovascular deaths was more than threefold (HR = 3.53; 95% CI: 1.46, 8.54). These ratios remained consistent after adjusting for covariates. In the most comprehensive Cox model, the HR for all-cause mortality was 2.43 (95% CI: 1.38, 4.23) and for cardiovascular mortality was 3.52 (95% CI: 1.40, 8.84), similar to results from the modified CHA2DS2-VASc score.
CONCLUSIONS: The results support the CHA2DS2-VASc score as a practical tool for identifying MHD patients at higher risk of mortality, especially from cardiovascular causes. </p>.
METHODS: Data are from the "Prospective Study of the Prognosis of Patients on Chronic Hemodialysis" (PROHEMO) in Salvador, Brazil. Patients were divided by CHA2DS2-VASc scores: ≤2 and >2. Cox regression estimated hazard ratios (HR) for death, both unadjusted and adjusted for confounders. We assessed the distribution of each score variable and its association with mortality. A modified CHA2DS2-VASc score was created due to the low percentage of patients over 75 (1.3%) and normotensive (4.6%).
RESULTS: A total of 237 patients (mean age 51.6 years; 57.0% male) were included in the study. There were 55 deaths, 21 from cardiovascular causes. For patients with a CHA2DS2-VASc score >2, the unadjusted hazard of all-cause mortality was doubled (HR = 2.05; 95% CI: 1.20, 3.49) compared to those with a score ≤2, and the risk for cardiovascular deaths was more than threefold (HR = 3.53; 95% CI: 1.46, 8.54). These ratios remained consistent after adjusting for covariates. In the most comprehensive Cox model, the HR for all-cause mortality was 2.43 (95% CI: 1.38, 4.23) and for cardiovascular mortality was 3.52 (95% CI: 1.40, 8.84), similar to results from the modified CHA2DS2-VASc score.
CONCLUSIONS: The results support the CHA2DS2-VASc score as a practical tool for identifying MHD patients at higher risk of mortality, especially from cardiovascular causes. </p>.