Septicemia and mortality after noncardiac surgery associated with CHA2DS2-VASc score: a retrospective cohort study based on a real-world database

• Published in: BMC surgery Vol. 21; no. 1; p. 209
• Main Authors: Sung, Li-Chin, Liu, Chih-Chung, Lin, Chao-Shun, Yeh, Chun-Chieh, Cherng, Yih-Giun, Chen, Ta-Liang, Liao, Chien-Chang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.04.2021; BioMed Central; BMC
• Subjects: Adult; Analysis; Atrial Fibrillation; Cardiovascular disease; CHA2DS2-VASc score; Chronic obstructive pulmonary disease; Cohort analysis; Complications; Confidence intervals; Diabetes; Expenditures; Fibrillation; Health insurance; Heart failure; Hospitalization; Hospitals; Humans; Hypertension; Infectious complications; Intensive care; Kidney diseases; Liver cirrhosis; Low income groups; Mental disorders; Mortality; National health insurance; Parkinson's disease; Patient outcomes; Patients; Pneumonia; Retrospective Studies; Risk Assessment; Risk Factors; Sepsis; Sepsis - epidemiology; Septicemia; Stroke; Surgery; Taiwan - epidemiology; Trends; Urinary tract diseases; Urogenital system; Young Adult; Taiwan; Infectious complications; CHA2DS2-VASc score; Atrial fibrillation; Mortality; Surgery
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-021-01209-z

Little was know about the association between the CHA2DS2-VASc score and postoperative outcomes. Our purpose is to evaluate the effects of CHA2DS2-VASc score on the perioperative outcomes in patients with atrial fibrillation (AF). We identified 47,402 patients with AF over the age of 20 years who underwent noncardiac surgeries between 2008 and 2013 from claims data of the National Health Insurance in Taiwan. The CHA2DS2-VASc score was used to evaluate postoperative complications, mortality and the consumption of medical resources by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with patients with a CHA2DS2-VASc score of 0, patients with scores ≥ 5 had an increased risk of postoperative septicemia (OR 2.76, 95% CI 2.00-3.80), intensive care (OR 2.55, 95% CI 2.12-3.06), and mortality (OR 2.04, 95% CI 1.14-3.64). There was a significant positive correlation between risk of postoperative complication and the CHA2DS2-VASc score (P < 0.0001). The CHA2DS2-VASc score was highly associated with postoperative septicemia, intensive care, and 30-day mortality among AF patients. Cardiologists and surgical care teams may consider using the CHA2DS2-VASc score to evaluate perioperative outcome risks in patients with AF.