The role of the modified CHA₂DS₂-VASc HSF score in predicting life-threatening events and mortality in hemodialysis patients

Chronic kidney disease (CKD) is an increasing global public health concern associated with high morbidity and mortality rates. A substantial proportion of patients with advanced CKD require hemodialysis (HD) therapy to sustain life. From the early stages of CKD, HD patients are exposed to various complications and face a significantly elevated risk of mortality. This underscores the critical importance of timely identification and management of risk factors. The relationship between the modified CHA₂DS₂-VASc HSF score and clinical outcomes such as prognosis and mortality has been evaluated in several studies. This thesis aims to investigate the utility of the modified CHA₂DS₂-VASc HSF score in predicting myocardial infarction, need for cardiac revascularization, stroke, and all-cause mortality in patients undergoing chronic HD. This multicenter retrospective study evaluated hospital data from 2023. A total of 248 patients aged 18 years or older who had been receiving HD treatment for at least three months were included. Modified CHA₂DS₂-VASc HSF scores were calculated using baseline data from the beginning of 2023, and patients were followed for one year to identify occurrences of myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, stroke, and death. Of the patients included, 60.1% were male, with a mean age of 62.8±13.1 years. The mean CHA₂DS₂-VASc HSF score was 3.64±1.8. During the follow-up period, 3.2% experienced major cardiac events, 2.8% had cerebrovascular events, and 11.3% died. A CHA₂DS₂-VASc HSF score ≥4.5 was found to be statistically significant in predicting both mortality (p=0.000) and stroke (p=0.002). In conclusion, the modified CHA₂DS₂-VASc HSF score appears to be a practical and effective screening tool for predicting stroke and all-cause mortality in HD patients and may contribute to risk stratification and clinical decision-making in this high-risk population. Keywords: Hemodialysis, CHA₂DS₂-VASc HSF, Prognosis, Mortality