title: CHA₂DS₂-VASc scores predict mortality after hospitalization for atrial fibrillation.
abstract: OBJECTIVE
  The outcome of patients hospitalized for atrial fibrillation (AF) is relatively poor. We sought to determine the mortality rate and predictors of mortality following hospitalization for AF and to evaluate whether the CHA2DS2-VASc score was a predictor of mortality.
  
  
  METHODS
  We examined the national database of Thailand residents who registered for government provided health insurance in 2005 and reviewed patient records from 2005 to 2010 to determine all-cause mortality. A total of 8981 patients (mean age, 65 years; 42% male) were admitted to the hospital with a diagnosis of AF. Data on demographics and comorbidities were retrieved from the database. The CHA2DS2-VASc score was calculated for each patient.
  
  
  RESULTS
  The hospitalization rate for AF was 15.5 per 100,000 person-years. The two most common comorbidities were hypertension (N=1638, 18.2%) and diabetes (N=1349, 15.0%). The average CHA2DS2-VASc score for all patients was 1.8. By the 72-month follow-up (average 46 months), 3948 patients (44.0%) had died. The CHA2DS2-VASc score was directly related to the mortality rate (P log-rank <0.0001). Multivariate analysis showed that a CHA2DS2-VASc score ≥ 6 (hazard ratio [HR] 2.2, 95% confidence interval [CI], 1.4-3.7, P=0.002) and the presence of chronic kidney disease (HR 2.0, 95% CI 1.7-2.4, P<0.0001) were the strongest predictors of death.
  
  
  CONCLUSIONS
  The outcome after hospitalization for AF is relatively poor. The CHA2DS2-VASc score is an independent prognostic marker of poor outcomes following hospitalization for AF.
authors.affiliation: Division of Cardiology, Department of Medicine, Ramathibodi Hospital, Bangkok, Thailand. Electronic address: sirin.api@mahidol.ac.th.
authors.forename: Sirin
authors.initials: S
authors.lastname: Apiyasawat
authors.affiliation: Division of Cardiology, Department of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
authors.forename: Tarinee
authors.initials: T
authors.lastname: Tangcharoen
authors.affiliation: Division of Cardiology, Department of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
authors.forename: Treechada
authors.initials: T
authors.lastname: Wisaratapong
authors.affiliation: Division of Cardiology, Department of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
authors.forename: Sukit
authors.initials: S
authors.lastname: Yamwong
authors.affiliation: Ministry of Public Health, Bangkok, Thailand.
authors.forename: Suwit
authors.initials: S
authors.lastname: Wiboonpolprasert
authors.affiliation: Division of Cardiology, Department of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
authors.forename: Piyamitr
authors.initials: P
authors.lastname: Sritara
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013785:Thailand / Q000453:epidemiology
keywords: Atrial fibrillation; CHA(2)DS(2)-VASc; Hospitalization; Mortality