The Role Of CHADS₂ And CHA₂DS₂-VASc Score In Evaluating The Prognosis Of Maintenance Hemodialysis Patients

0bjective To investigate the role of CHADS₂ and CHA₂DS₂-VASc scores in evaluating the prognosis of maintenance hemodialysis?MHD?patients.Methods From January 2017 to June 2018,112 patients who were treated with MHD in our blood purification center were enrolled.The patients were graded with CHADS₂ and CHA₂DS₂-VASc scores.According to the two kinds of scores,the patients were divided into three groups:group 1:0-1,group 2:2-3,Group 3:?4scores.Kaplan-Meier survival analysis was used to compare the differences of all causes of death,cardiovascular events and cerebrovascular events in each group.Multivariate COX regression analysis was used to analyze the influencing factors of all-cause death,cardiovascular events and cerebrovascular events.Area?AUC?under operating characteristic curve?ROC?was used to evaluate the predictive value of CHADS₂ score and CHA ₂DS₂-VASc score for all-cause death,cardiovascular events and cerebrovascular events.Results The incidence of all-cause death was statistically significant in CHADS₂score group.The higher the score is,the higher the risk of death is?P<0.01?.There was no significant significance in the occurrence of cardiovascular events in three groups?P=0.057?.The occurrence of cerebrovascular events was statistically significant in CHADS₂ score group.The higher the score is,the higher the risk of cerebrovascular events is?P<0.01?.CHA₂DS₂-VASc score showed statistical significance in all death,cardiovascular events and cerebrovascular events in the three groups.The higher the score is,the higher the risk of all death cardiovascular events and cerebrovascular events is?all P<0.05?.Multivariate COX regression analysis showed that CHA₂DS₂-VASc score?HR=1.772,95%CI:1.414².220,P<0.01?and Troponin I?cTnI??HR=1.150,95%CI:1.025¹.290,P=0.018?were all risk factors of all-cause death in MHD patients.CHA₂DS₂-VASc score?HR=1.590,95%CI:1.219².073,P=0.001?was an independent risk factor for cardiovascular events in MHD patients.CHADS₂ and CHA₂DS₂-VASc scores were not the independent risk factors of cerebrovascular events in patients with MHD.CHADS₂ and CHA₂DS₂-VASc scores had a good predictive value for all-cause death?CHADS₂ AUC=0.767,P<0.01 and CHA₂DS₂-VASc AUC=0.785,P<0.01?.CHA₂DS₂-VASc score had a better predictive value for cardiovascular events?AUC=0.697,P=0.008?.CHADS₂ and CHA₂DS₂-VASc scores had a good predictive value for cerebrovascular events.?CHADS₂ AUC=0.787,P<0.01 and CHA₂DS₂-VASc AUC=0.683,P<0.05?.Conclusions CHA₂DS₂-VASc scores can predict the incidence of all-cause death in MHD patients.CHA₂DS₂-VASc score and cTnI are risk factors of all-cause death in MHD patients.CHA₂DS₂-VASc score can predict the occurrence of cardiovascular events in MHD patients and is an independent risk factor for cardiovascular events.Both CHADS₂ and CHA₂DS₂-VASc scores were not related to the occurrence of cerebrovascular events in patients with MHD and had low predictive value for the occurrence of cerebrovascular events in patients with MHD.