Evaluation of CHA2DS2-VASc score and R2CHADS2 score in patients with acute pulmonary thromboembolism and right ventricular dysfunction

Abstract

Background and Aim: Acute pulmonary embolism (APE) is one of the fatal emergencies. Imaging methods are not available to all physicians as an emergency and depend on the individual. For this reason, besides imaging methods, more easily applicable and individual-independent parameters are investigated to help the diagnosis. Some scoring systems are also used according to the patient's current disease status. R2CHADS2 score is used more in patients with chronic renal failure (CRF). The aim of the study was to compare CHA2DS2-VASc and R2CHADS2 scores in patients with APE and right ventricular dysfunction (RVD). Methods: The study was conducted retrospectively. The patient group of the study consisted of 392 patients diagnosed with APE. Patients with nonmassive pulmonary embolism and submassive pulmonary embolism (SPE) without RVD were defined as Group 1 (n = 213) and massive pulmonary embolism and SPE with RVD were defined as Group 2 (n = 179). CHA2DS2-VASc and R2CHADS2 scores were compared as a scoring system in patients. Results: CHA2DS2-VASc scores and R2CHADS2 scores were evaluated in the two groups. The R2CHADS2 score was statistically significant in Group 2 (P < 0.001). There was a statistically significant difference between the groups in terms of CRF and estimated glomerular filtration rate (15 [7.2%] vs. 29 [16.4%], P < 0.001, and 57.6 vs. 46.4 mL/min/1.73 m2, P < 0.001). Conclusions: Our findings show that the CHA2DS2-VASc score and R2CHADS2 are independent predictors of RVD in patients with APE. However, the R2CHADS2 scoring system is observed better than the CHA2DS2-VASc scoring system in patients with APE and RVD.