title: CHADS2 and CHA2DS2-VASc scores can predict thromboembolic events after supraventricular arrhythmia in the critically ill patients.
abstract: OBJECTIVE
  Prediction of arterial thromboembolic events (ATEs) in relation to supraventricular arrhythmia (SVA) has been poorly investigated in the intensive care unit (ICU). We aimed at evaluating CHADS2 and CHA2DS2-VASc scores to predict SVA-related ATE in the ICU.
  
  
  METHODS
  We conducted a prospective observational study including all the patients except those in the postoperative course of cardiac surgery who presented SVA lasting 30 seconds or longer during their ICU stay. We looked for ATE during ICU stay, at the first and sixth month of follow-up after ICU discharge.
  
  
  RESULTS
  During the 15-month study period, 108 (12.8%) of 846 ICU patients experienced SVA with 12 SVA-related ATE occurring 6 days (3; 13) (median, 10%-90% percentiles) after SVA onset. In our SVA patients, CHADS2 score was 2 (0; 5), and CHA2DS2-VASc score 3 (0; 7). Both CHADS2 (odds ratio (OR), 1.6 [1.1; 2.4]; P = .01) and CHA2DS2-VASc scores (OR, 1.4 [1.04; 1.8]; P = .03) were significantly associated with ATE onset. However, the most accurate threshold for predicting ATE was CHADS2 score of 4 or higher. Using a multivariate analysis, only patient's history of stroke was associated with ATE onset (OR, 9.2 [2.4; 35]; P = .001).
  
  
  CONCLUSIONS
  CHADS2 and CHA2DS2-VASc scores are predictive of SVA-related thromboembolism in the critically ill patient.
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France; Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris-Diderot, Paris, France. Electronic address: champion.seb@wanadoo.fr.
authors: Sébastien
authors: S
authors: Champion
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Yannick
authors: Y
authors: Lefort
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Bernard-Alex
authors: BA
authors: Gaüzère
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Didier
authors: D
authors: Drouet
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Bruno Julien
authors: BJ
authors: Bouchet
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Guillaume
authors: G
authors: Bossard
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Sabina
authors: S
authors: Djouhri
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: David
authors: D
authors: Vandroux
authors: Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France.
authors: Kushal
authors: K
authors: Mayaram
authors: Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris-Diderot, Paris, France; INSERM U1144, Université Paris-Descartes, Paris, France. Electronic address: bruno-megarbane@wanadoo.fr.
authors: Bruno
authors: B
authors: Mégarbane
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D016638:Critical Illness; D003920:Diabetes Mellitus; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000209:etiology; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000401:mortality; D013923:Thromboembolism / Q000209:etiology*; D013997:Time Factors
keywords: Atrial fibrillation; CHA2DS2-VASc; CHADS2; Intensive care unit; Supraventricular arrhythmia; Thromboembolism