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Evaluation of the CHADS2 risk score on short- and long-term all-cause and cardiovascular mortality after syncope.
Ruwald, Martin Huth; Ruwald, Anne-Christine; Jons, Christian; Lamberts, Morten; Hansen, Morten Lock; Vinther, Michael; Køber, Lars; Torp-Pedersen, Christian; Hansen, Jim; Gislason, Gunnar Hilmar.
Afiliación
  • Ruwald MH; Department of Cardiology, Gentofte Hospital, Hellerup, Denmark. mruwald@hotmail.com
Clin Cardiol ; 36(5): 262-8, 2013 May.
Article en En | MEDLINE | ID: mdl-23450502
BACKGROUND: Syncope risk stratification is difficult and has not been implemented clinically. HYPOTHESIS: The CHADS2 score can be applied as a risk stratification tool for predicting mortality after an episode of syncope. METHODS: All patients discharged from emergency departments with a first-time diagnosis of syncope from 2001 to 2009 where identified from nationwide registers in Denmark and matched on sex and age with a control population. Risk of all-cause or cardiovascular death was analyzed by multivariable Cox models. RESULTS: A total of 37,705 patients were included. There were a total of 7761 deaths (21%), of which 52% were cardiovascular vs 27 862 (15%) deaths in the control population. The risk of cardiovascular death was significantly increased with increasing CHADS2 score (CHADS2 score: 1-2, hazard ratio [HR]: 9.11, 95% confidence interval [CI]: 8.25-10.07; CHADS2 score: 3-4, HR: 17.32, 95% CI: 15.42-19.47; CHADS2 score: 5-6, HR: 26.66, 95% CI: 21.40-33.21) relative to CHADS2 score of 0. A CHADS2 score of 0 was associated overall with very low event rates (15.1 deaths per 1000 person-years) but was associated with increased relative risk in the syncope population compared to controls. Syncope predicted 1-week, 1-year, and long-term mortality across CHADS2 scores compared to controls but did not reach significance in CHADS2 scores of 5 to 6. CONCLUSIONS: Increasing CHADS2 score significantly predicts mortality in patients discharged with a diagnosis of syncope, and a CHADS2 score of 0 was associated with a very low absolute mortality. Compared to controls, syncope was associated with increased short- and long-term mortality, particularly in the lower CHADS2 scores.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Síncope / Enfermedades Cardiovasculares Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Clin Cardiol Año: 2013 Tipo del documento: Article País de afiliación: Dinamarca

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Síncope / Enfermedades Cardiovasculares Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Clin Cardiol Año: 2013 Tipo del documento: Article País de afiliación: Dinamarca