Evaluating the HATCH score for predicting progression to sustained atrial fibrillation in ED patients with new atrial fibrillation - 11/05/13
, Wesley H. Self, MD, MPH a, Brian S. Wasserman, MD a, Candace D. McNaughton, MD, MPH a, Dawood Darbar, MD bAbstract |
Objectives |
Atrial fibrillation (AF) is often first detected in the emergency department (ED). Not all AF patients progress to sustained AF (ie, episodes lasting >7 days), which is associated with increased morbidity. The HATCH score stratifies patients with paroxysmal AF according to their risk for progression to sustained AF within 1 year. The HATCH score has previously never been tested in ED patients. We evaluated the accuracy of the HATCH score to predict progression to sustained AF within 1 year of initial AF diagnosis in the ED.
Methods |
We conducted a retrospective cohort study of 253 ED patients with new onset AF and known rhythm status for 1 year following the initial AF detection. The exposure variable was the HATCH score at initial ED evaluation. The primary outcome was rhythm status at 1 year following initial AF diagnosis. We constructed a receiver operating characteristic curve and calculated the area under the curve to estimate the HATCH score's accuracy of predicting progression to sustained AF.
Results |
Overall, 61 (24%) of 253 of patients progressed to sustained AF within 1 year of initial detection, and the HATCH score receiver operating characteristic area under the curve was 0.62 (95% confidence interval, 0.54-0.70).
Conclusions |
Among ED patients with new onset AF, the HATCH score was a modest predictor of progression to sustained AF. Because only 2 patients had a HATCH greater than 5, this previously recommended cut-point was not useful in identifying high-risk patients in this cohort. Refinement of this decision aid is needed to improve its prognostic accuracy in the ED population.
Le texte complet de cet article est disponible en PDF.Plan
| ☆ | Funding sources: No industry financial support or compensation has been or will be received for conducting this study. Dr Barrett and this study are funded by National Institutes of Health (NIH) grant K23 HL102069 from the National Heart, Lung and Blood Institute. Dr Self is supported in part by an NIH KL2 grant through the Vanderbilt University School of Medicine Clinical and Translational Science Award. Drs Wasserman and McNaughton are supported by NIH grant K12HL109019 from the National Heart, Lung and Blood Institute. Dr Darbar is supported in part by NIH grants U01 HL65962 and R01 HL092217. |
Vol 31 - N° 5
P. 792-797 - mai 2013 Retour au numéro
Article précédent
- Factors associated with use of emergency medical services in patients with acute stroke
- Nai-Chuan Chen, Ming-Ju Hsieh, Sung-Chun Tang, Wen-Chu Chiang, Kuang-Yu Huang, Li-Kai Tsai, Patrick Chow-In Ko, Matthew Huei-Ming Ma, Jiann-Shing Jeng
- An after-action review tool for EDs: learning from mass casualty incidents
- Greenberg Tami, Adini Bruria, Eden Fabiana, Chen Tami, Ankri Tali, Aharonson-Daniel Limor
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?