Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
First Department of Cardiology and Angiology, Silesian Centre for Heart Disease, Curie-Sklodowskiej Str 9, 41-800 Zabrze, Poland.
Europace. 2021 Feb 5;23(2):314-322. doi: 10.1093/europace/euaa358.
This European Heart Rhythm Association (EHRA) Scientific Initiatives Committee, EHRA Young Electrophysiologists, Association of Cardiovascular Nursing and Allied Professionals, and European Society of Cardiology (ESC) Council on Stroke joint survey aimed to assess the interpretation of the CHA2DS2-VASc score components and preferred resources for calculating the score. Of 439 respondents, most were general cardiologists (46.7%) or electrophysiologists (EPs) (42.1%). The overall adherence to the ESC-defined scoring criteria was good. Most variation was observed in the interpretation of the significance of left ventricular ejection fraction and brain natriuretic peptide in the scoring for the 'C' component, as well as the 'one-off high reading of blood pressure' to score on the 'H' component. Greater confidence was expressed in scoring the 'H' component (72.3%) compared with the 'C' (46.2%) and 'V' (45.9%) components. Respondents mainly relied on their recall for the scoring of CHA2DS2-VASc score (64.2%). The three most favoured referencing resources varied among different professionals, with pharmacists and physicians relying mainly on memory or web/mobile app, whereas nurses favoured using a web/mobile app followed by memory or guidelines/protocol. In conclusion, this survey revealed overall good adherence to the correct definition of each component in scoring of the 'C', 'H', and 'V' elements of the CHA2DS2-VASc score, although the variation in their interpretations warrants further clarifications. The preferred referencing resources to calculate the score varied among different healthcare professionals. Guideline education to healthcare professionals and updated and unified online/mobile scoring tools are suggested to improve the accuracy in scoring the CHA2DS2-VASc score.
这项由欧洲心脏病学会（ESC）心律协会（EHRA）科学倡议委员会、EHRA 青年电生理学家、心血管护理和相关专业协会以及 ESC 卒中理事会联合开展的调查旨在评估 CHA2DS2-VASc 评分成分的解读以及计算评分的首选资源。在 439 名受访者中，大多数是普通心脏病专家（46.7%）或电生理学家（42.1%）。总体而言，对 ESC 定义的评分标准的遵循情况良好。在“C”成分的评分中，对左心室射血分数和脑利钠肽的意义的解释以及在“H”成分中对血压“一次性高读数”的评分存在最大的差异。与“C”（46.2%）和“V”（45.9%）成分相比，对“H”成分的评分表现出更大的信心（72.3%）。受访者主要依靠回忆来进行 CHA2DS2-VASc 评分（64.2%）。不同专业人员最青睐的参考资源各不相同，药剂师和医生主要依赖于记忆或网络/移动应用程序，而护士则更倾向于使用网络/移动应用程序，其次是记忆或指南/方案。总之，这项调查显示，在对 CHA2DS2-VASc 评分的“C”、“H”和“V”元素的评分中，总体上对每个成分的正确定义的遵循情况良好，尽管它们的解释存在差异，需要进一步澄清。不同医疗保健专业人员首选的计算评分的参考资源各不相同。建议向医疗保健专业人员提供指南教育，并更新和统一在线/移动评分工具，以提高 CHA2DS2-VASc 评分的准确性。
