CHA(2)DS(2)-VASc scores predict mortality after hospitalization for atrial fibrillation

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 CHA(2)DS(2)-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 CHA(2)DS(2)-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 CHA(2)DS(2)-VASc score for all patients was 1.8. By the 72-month follow-up (average 46 months), 3948 patients (44.0%) had died. The CHA(2)DS(2)-VASc score was directly related to the mortality rate (P log-rank <0.0001). Multivariate analysis showed that a CHA(2)DS(2)-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. Conclusion: The outcome after hospitalization for AF is relatively poor. The CHA(2)DS(2)-VASc score is an independent prognostic marker of poor outcomes following hospitalization for AF. (C) 2015 Elsevier Ireland Ltd. All rights reserved.