• Sébastien Champion, Yannick Lefort, Bernard-Alex Gaüzère, Didier Drouet, Bruno Julien Bouchet, Guillaume Bossard, Sabina Djouhri, David Vandroux, Kushal Mayaram, and Bruno Mégarbane.
• Service de réanimation polyvalente, CHU de la Réunion, hôpital Félix-Guyon, 97405 Saint-Denis, La Réunion, France; Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris-Diderot, Paris, France. Electronic address: champion.seb@wanadoo.fr.
• J Crit Care. 2014 Oct 1;29(5):854-8.

PurposePrediction of arterial thromboembolic events (ATEs) in relation to supraventricular arrhythmia (SVA) has been poorly investigated in the intensive care unit (ICU). We aimed at evaluating CHADS2 and CHA2DS2-VASc scores to predict SVA-related ATE in the ICU.MethodsWe conducted a prospective observational study including all the patients except those in the postoperative course of cardiac surgery who presented SVA lasting 30 seconds or longer during their ICU stay. We looked for ATE during ICU stay, at the first and sixth month of follow-up after ICU discharge.ResultsDuring the 15-month study period, 108 (12.8%) of 846 ICU patients experienced SVA with 12 SVA-related ATE occurring 6 days (3; 13) (median, 10%-90% percentiles) after SVA onset. In our SVA patients, CHADS2 score was 2 (0; 5), and CHA2DS2-VASc score 3 (0; 7). Both CHADS2 (odds ratio (OR), 1.6 [1.1; 2.4]; P = .01) and CHA2DS2-VASc scores (OR, 1.4 [1.04; 1.8]; P = .03) were significantly associated with ATE onset. However, the most accurate threshold for predicting ATE was CHADS2 score of 4 or higher. Using a multivariate analysis, only patient's history of stroke was associated with ATE onset (OR, 9.2 [2.4; 35]; P = .001).ConclusionCHADS2 and CHA2DS2-VASc scores are predictive of SVA-related thromboembolism in the critically ill patient.Copyright © 2014 Elsevier Inc. All rights reserved.

35 keywords...

hide…