Abstract 13696: Temporal Trends In Chads2 And Cha2ds2vasc Comorbidities And Association With Outcomes In Atrial Fibrillation Patients Presenting With Acute Ischemic Stroke And Transient Ischemic Attack

Abstract

Introduction: CHADSVASc and CHADS scores, developed early in the last decade, are used to predict risk of acute ischemic strokes and transient ischemic attacks(CVA/TIA) in Atrial fibrillation(Afib) Hypothesis: We wanted to study temporal trends of these scores and association with mortality and morbidity (defined as discharge to facility apart from home or to home with services). Methods: Admissions with CVA/TIA in Afib were identified using DRG codes from 2008 to 2017 from the National Inpatient Sample. Comorbidities were identified using ICD codes (ICD9 2008-2015 quarter3 and ICD10 from 2015 quarter 4-2017). Results: Total 66,280 admissions were identified. Mean CHADS and Mean CHADSVASC scores increased over time (4.01 ± 0.8) to (4.19 ± 0.8) and (5.88 ± 1.3) to (6.02 ± 1.3) in 2008 to 2017 respectively (p trend<0.001). Prevalence of heart failure, hypertension, diabetes and peripheral vascular disease increased significantly whereas mean age, proportion of patients ≥75 and female decreased significantly across the years (p trend for all<0.001). Inpatient mortality rates increased over the years (2.69 vs 2.90%) (p trend<0.001). Higher CHADSVASC score and CHADS score were independently associated with mortality (OR1.35,p<0.001;OR1.32,p<0.001 respectively), discharge to a facility apart from home(OR1.26,p<0.001;OR1.30,p<0.001 respectively) or to home with services (OR1.30,p<0.001;1.33,p<0.001 respectively). Conclusions: We found that CHADSVASC/CHADS scores increased, with an increase in the prevalence of all risk actors except age and female gender from 2007 to 2018. High scores correlated with mortality and morbidity in these younger patients.