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比较 CHADS-VASc 和 AHEAD 评分在预测因心力衰竭住院患者发生痴呆方面的表现:一项全国性队列研究。

Comparison of CHADS-VASc and AHEAD scores for the prediction of incident dementia in patients hospitalized for heart failure: a nationwide cohort study.

机构信息

School of Medicine, College of Medicine, China Medical University, Taichung, 40402, Taiwan.

Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan.

出版信息

Intern Emerg Med. 2019 Apr;14(3):395-402. doi: 10.1007/s11739-018-1961-4. Epub 2018 Oct 10.

Abstract

This study explores the use of the CHADS-VASc and the AHEAD scores to predict incident dementia in patients with heart failure (HF) who need hospitalization. We used a large national database to study 387,595 adult patients hospitalized for HF from Taiwan. This registration cohort was followed to document the cumulative incidence of dementia. The area under the curve of receiver operating characteristics (AUROC) was used to evaluate the discriminative ability of CHADS-VASc and AHEAD scores in predicting dementia, whereas the DeLong test was used to examine the difference between the predictive capacity. A higher CHADS-VASc and AHEAD scores appear to be more strongly associated with a higher incidence of dementia. The AUROC for CHADS-VASc score in predicting dementia (0.61, 95% CI = 0.60-0.61) is significantly higher than the AHEAD score (0.55, 95% CI = 0.54-0.55) (DeLong test p < 0.001). A significantly higher ability, by AUROC, of CHADS-VASc score to predict new-onset dementia in patients hospitalized for HF is found.

摘要

这项研究探讨了 CHADS-VASc 和 AHEAD 评分在预测需要住院治疗的心力衰竭 (HF) 患者新发痴呆症中的作用。我们使用了一个大型国家数据库,研究了来自中国台湾的 387,595 名因 HF 住院的成年患者。该登记队列用于记录痴呆症的累积发生率。受试者工作特征曲线下面积 (AUROC) 用于评估 CHADS-VASc 和 AHEAD 评分预测痴呆症的区分能力,而 DeLong 检验用于检验预测能力的差异。较高的 CHADS-VASc 和 AHEAD 评分似乎与更高的痴呆症发病率更密切相关。CHADS-VASc 评分预测痴呆症的 AUROC(0.61,95%CI=0.60-0.61)显著高于 AHEAD 评分(0.55,95%CI=0.54-0.55)(DeLong 检验,p<0.001)。发现 CHADS-VASc 评分对预测 HF 住院患者新发痴呆症的能力,通过 AUROC 显著提高。

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