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Prevalence of atrial fibrillation and the HATCH score

Intensified monitoring of patients with high HATCH score

Prävalenz von Vorhofflimmern und der HATCH-Score

Intensiviertes Monitoring bei Patienten mit hohem HATCH-Score

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Abstract

Aim

The HATCH score [hypertension, age > 75 years, previous transient ischemic attack (TIA) or stroke (doubled), chronic obstructive pulmonary disease, heart failure (doubled)] has been established to identify patients who are at risk of developing persistent forms of AF. We investigated whether this score is associated with the prevalence of AF in order to guide diagnostic efforts and therapy.

Patients and methods

The data of 150,408 consecutive patients who were hospitalized at the University Hospital of Rostock between 2007 and 2012 were analyzed. Factors constituting the HATCH score and the presence of AF were prospectively documented using ICD-10 admission codes.

Results

Patients were 67.6 ± 13.6 years of age with a mean HATCH score of 1.48 ± 1.02; 16 % had a history of AF and 4 % suffered a TIA or stroke. The prevalence of AF increased significantly with the HATCH score up to 60.0 % (p < 0.001). In all, 63 % of the patients had a HATCH score of 0 and 1 without any history of stroke.

Conclusion

The HATCH score correlates with the occurrence of AF, since the prevalence of AF rises with rising score values. Therefore, the HATCH score may be used to select patients for intensified ECG monitoring. Moreover, the score may also be used for stroke risk assessment, as none of the patients with a low HATCH score suffered a stroke.

Zusammenfassung

Zielsetzung

Der HATCH-Score [arterielle Hypertonie, Alter > 75 Jahre, transitorische ischämische Attacke (TIA) oder Schlaganfall (doppelt), chronisch obstruktive Lungenerkrankung, Herzinsuffizienz (doppelt)] wurde etabliert, um diejenigen Patienten mit Vorhofflimmern zu identifizieren, bei denen ein hohes Risiko besteht, dass eine persistierende Form der Rhythmusstörung auftritt. In der vorliegenden Arbeit untersuchten die Autoren, inwieweit der HATCH-Score mit der Prävalenz von Vorhofflimmern assoziiert ist und ob anhand dessen diagnostische Strategien oder Therapien abgeleitet werden können.

Patienten und Methoden

Die vorliegende Analyse umfasste 150.408 konsekutive Patienten, die am Universitätsklinikum Rostock zwischen 2007 und 2012 behandelt wurden. Die Faktoren, welche den HATCH-Score bilden, wurden mittels ICD-10-Aufnahmecodierungen prospektiv ermittelt, ebenso das Vorhandensein von Vorhofflimmern.

Ergebnisse

Das Durchschnittsalter der Patienten lag bei 67,6 ± 13,6 Jahren, sie wiesen im Mittel einen HATCH-Score von 1,48 ± 1,02 auf. Bei 16 % der Patienten war Vorhofflimmern bekannt, 4 % aller Studienteilnehmer hatten bereits eine TIA oder einen Schlaganfall erlitten. Die Prävalenz von Vorhofflimmern stieg signifikant mit zunehmendem HATCH-Score bis auf 60 % an (p < 0,001). Bei 63 % der Patienten betrug der HATCH-Score null oder eins, und keiner dieser Patienten hatte bisher einen Schlaganfall erlitten.

Schlussfolgerung

Der HATCH-Score korreliert mit dem Auftreten von Vorhofflimmern, da die Prävalenz von Vorhofflimmern mit zunehmenden Score-Werten ansteigt. Deshalb könnte der HATCH-Score dazu verwendet werden, Patienten zu selektieren, welche intensivierter mittels EKG überwacht werden sollten. Zudem könnte der HATCH-Score auch zur Schlaganfallrisikostratifizierung herangezogen werden, denn kein Patient mit niedrigem HATCH-Score hatte einen Schlaganfall erlitten.

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Authors and Affiliations

  1. Heart Center Rostock, Uniklinik Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany

    Tina S. Tischer MD, Ralph Schneider MD, Jörg Lauschke MD & Dietmar Bänsch MD, PHD

  2. Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Hospital, Rostock, Germany

    Doreen Diedrich & Günther Kundt PhD

Authors
  1. Tina S. Tischer MD
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  2. Ralph Schneider MD
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Correspondence to Dietmar Bänsch MD, PHD.

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T.S. Tischer, R. Schneider, J. Lauschke, D. Diedrich, G. Kundt, and D. Bänsch state that there are no conflicts of interest.

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Tischer, T., Schneider, R., Lauschke, J. et al. Prevalence of atrial fibrillation and the HATCH score. Herz 40, 803–808 (2015). https://doi.org/10.1007/s00059-015-4305-4

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