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Modified M-CHA2DS2-VASc score predicts mortality at emergency department admission in COVID-19 patients
Session:
Posters (Sessão 5 - Écran 6) - DAC e Cuidados Intensivos 7 - Marcadores de Risco e Prognóstico
Speaker:
Ana Beatriz Garcia
Congress:
CPC 2022
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
14. Acute Cardiac Care
Subtheme:
14.2 Acute Cardiac Care – Prehospital and Emergency Department Care
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Beatriz Garcia; Beatriz Valente Silva; Sara Couto Pereira; Pedro Silvério António; Pedro Alves da Silva; Joana Brito; Catarina Simões de Oliveira; Ana Margarida Martins; Catarina Gregório; Ana Abrantes; Miguel Azaredo Raposo; Carlos Mendonça; Luísa Urbano; Tiago Rodrigues; Cláudia Jorge; Rui Plácido; Fausto j. Pinto
Abstract
<p style="margin-left:-29px; margin-right:-38px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Introduction</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: Many risk factors comprising the CHA2DS2VASc score are recognized as risk factors for venous thromboembolism and mortality in COVID-19 patients. A modified CHA2DS2VASc score (M-CHA2D2VASc), created by changing gender criteria from female to male, has been proposed to predict in-hospital mortality in COVID-19 patients.</span></span></span></p> <p style="margin-left:-29px; margin-right:-38px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Purpose</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: To evaluate the prognostic value of M-CHA2D2VASc to predict pulmonary embolism (PE) and short-term mortality in COVID-19 patients admitted to the Emergency Department (ED).</span></span></span></p> <p style="margin-left:-29px; margin-right:-38px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Methods</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: Retrospective study of consecutive patients admitted to the ED who underwent computed tomography pulmonary angiography due to clinical worsening. Patients were stratified into three M-CHA2DS2VASc risk categories: low (0-1 points), intermediate (2-3 points) and high risk (</span></span></span><span style="font-size:11pt"><span style="font-family:Symbol"><span style="color:#000000">≥</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">4 points). </span></span></span></p> <p style="margin-left:-29px; margin-right:-38px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Results</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: We included 300 patients (median age 71 years, 59% male). The PE incidence was 15%, and no difference was found in PE incidence according to M-CHA2DS2VASc categories (p=0.531). The overall mortality was 27% (median follow-up: 56 days). M-CHA2DS2VASc was higher in non-survivors than in survivors [4 (IQR 3-5) vs 2 (IQR 1-4), respectively, p<0.001). M-CHA2DS2VASc was identified as an independent predictor of mortality in a multivariate logistic regression analysis (OR 1.406, p=0.007). Kaplan-Meier showed that M-CHA2DS2VASc was associated with short-term mortality (log-rank test <0.001): the survival rate was 92%, 80% and 63% in the lower, intermediate and higher risk groups. The prognostic value of M-CHA2DS2VASc was maintained whether the patients were hospitalized or discharged from ED (log-rank test p<0.001 and p=0.007, respectively). </span></span></span></p> <p style="margin-left:-29px; margin-right:-38px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><strong>Conclusion</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">: M-CHA2DS2VASC might be a simple score to predict short-term mortality in COVID-19 patients admitted to the ED.</span></span></span></p>
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