Abstract:
BACKGROUND:Contemporary clinical risk stratification schemata for predicting stroke and thromboembolism (TE) in patients with atrial fibrillation (AF) are largely derived from risk factors identified from trial cohorts. Thus, many potential risk factors have not been included. METHODS:We refined the 2006 Birmingham/National Institute for Health and Clinical Excellence (NICE) stroke risk stratification schema into a risk factor-based approach by reclassifying and/or incorporating additional new risk factors where relevant. This schema was then compared with existing stroke risk stratification schema in a real-world cohort of patients with AF (n = 1,084) from the Euro Heart Survey for AF. RESULTS:Risk categorization differed widely between the different schemes compared. Patients classified as high risk ranged from 10.2% with the Framingham schema to 75.7% with the Birmingham 2009 schema. The classic CHADS(2) (Congestive heart failure, Hypertension, Age > 75, Diabetes, prior Stroke/transient ischemic attack) schema categorized the largest proportion (61.9%) into the intermediate-risk strata, whereas the Birmingham 2009 schema classified 15.1% into this category. The Birmingham 2009 schema classified only 9.2% as low risk, whereas the Framingham scheme categorized 48.3% as low risk. Calculated C-statistics suggested modest predictive value of all schema for TE. The Birmingham 2009 schema fared marginally better (C-statistic, 0.606) than CHADS(2). However, those classified as low risk by the Birmingham 2009 and NICE schema were truly low risk with no TE events recorded, whereas TE events occurred in 1.4% of low-risk CHADS(2) subjects. When expressed as a scoring system, the Birmingham 2009 schema (CHA(2)DS(2)-VASc acronym) showed an increase in TE rate with increasing scores (P value for trend = .003). CONCLUSIONS:Our novel, simple stroke risk stratification schema, based on a risk factor approach, provides some improvement in predictive value for TE over the CHADS(2) schema, with low event rates in low-risk subjects and the classification of only a small proportion of subjects into the intermediate-risk category. This schema could improve our approach to stroke risk stratification in patients with AF.
journal_name
Chestjournal_title
Chestauthors
Lip GY,Nieuwlaat R,Pisters R,Lane DA,Crijns HJdoi
10.1378/chest.09-1584subject
Has Abstractpub_date
2010-02-01 00:00:00pages
263-72issue
2eissn
0012-3692issn
1931-3543pii
S0012-3692(10)60067-0journal_volume
137pub_type
杂志文章,多中心研究相关文献
CHEST文献大全abstract::We report the findings in two patients with sulfasalazine-induced pulmonary disease. The first patient developed pulmonary interstitial fibrosis after more than 4 yr of treatment for Crohn's disease. Pulmonary symptoms and chest roentgenographic and pulmonary function abnormalities gradually reversed after stopping th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.4.1033
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:COPD is a heterogeneous disease demonstrating inter-individual variation. A high COPD prevalence in Chinese populations is described, but little is known about disease clusters and prognostic outcomes in the Chinese population across Southeast Asia. We aim to determine if clusters of Chinese patients with CO...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.01.043
更新日期:2020-07-01 00:00:00
abstract::In order to assess the long-term clinical benefits of palliative Nd:YAG laser photoresection, we studied 69 patients with obstructing exophytic tracheobronchial lesions treated with this modality between Oct 25, 1984 and May 8, 1989. In 55 patients, there was greater than 75 percent restoration of the luminal caliber ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.3.581
更新日期:1990-09-01 00:00:00
abstract::The ventilator discontinuation process is a critical component of ICU care. Ongoing ventilator dependency is caused by both disease factors (eg, respiratory, cardiac, metabolic, and neuromuscular) and clinician management factors (eg, failing to recognize discontinuation potential and inappropriate ventilator settings...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.06-2862
更新日期:2007-09-01 00:00:00
abstract::A 57-year-old man with a history of exposure to silica for 32 years presented with pleural thickening of the lower lobe of the left lung and a chronic right-sided pleural effusion without any radiographic evidence of parenchymal nodules in either lung. Light microscopic examination of a left visceral pleural biopsy sp...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.112.5.1436
更新日期:1997-11-05 00:00:00
abstract:BACKGROUND:Changes in Paco(2) have not been described during thoracoscopy under sedation-assisted local anesthesia. We hypothesized that hypoventilation might occur secondary to administration of sedatives and decreased ventilation in one lung. AIM:Prospectively measure cutaneous carbon dioxide tension (Pcco(2)) in ad...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.2.585
更新日期:2005-02-01 00:00:00
abstract::In most studies, many statistical tests are performed. They can be run to compare the groups at baseline, look at relationships among the various measures, and, for intervention trials, examine more than one end point. As the number of tests increases, so does the probability of finding at least one of them to be stat...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.11-0523
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:This study attempts to determine the distribution of transudates vs exudates in pathologically proved malignant pleural effusions and the necessity for cytologic studies in patients with a transudative effusion. MATERIALS AND METHODS:A retrospective review of all cytologically positive malignant pleural effusi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.5.1302
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:The efficacy of a new pharmacologic agent for asthma, in this instance the leukotriene receptor antagonist montelukast, is determined in controlled trials in research subjects. The utility of a new drug is determined by multiple uncontrollable factors in individual patients. OBJECTIVE:To assess the utility ...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.121.2.334
更新日期:2002-02-01 00:00:00
abstract::Echocardiographic studies were performed in 86 patients with right ventricular volume overload. In 45 of these 86 patients, 58 echocardiograms were performed at different intervals in the postoperative period. For control purposes, 60 normal subjects and 18 patients with right ventricular pressure overload were also e...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.3.388
更新日期:1976-03-01 00:00:00
abstract:STUDY OBJECTIVES:Quadriceps fatigue can occur in patients with COPD after exhaustive cycle exercise. The purpose of this study was to determine whether the degree of fatigue elicited by cycle exercise was greater in patients with COPD compared with matched control subjects. SUBJECTS:Nine male patients with COPD with a...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.123.4.1104
更新日期:2003-04-01 00:00:00
abstract::Fifty-seven patients with rheumatoid arthritis (RA) were treated in hospital for diffuse interstitial lung fibrosis. Although interstitial fibrosis (either on the basis of lung function tests or chest roentgenograms or both) is fairly common among patients with RA, according to this study interstitial fibrosis of suff...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.1.114
更新日期:1988-01-01 00:00:00
abstract::Spirometry is a useful test of pulmonary function and can be safely performed in a variety of clinical situations. Although the technique for performing the maneuver is straightforward, there are many sources of variability in results. Specific criteria must be met in order for the test to be considered valid. For the...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.08-2315
更新日期:2009-08-01 00:00:00
abstract::Eighteen newly diagnosed cases of symptomatic cocidioidomycosis developed two to four weeks following exposure to a severe natural dust storm. The population at risk consisted of 26,000 residents of the San Joaquin Valley with access to health care at the Naval Hospital, Lemoore, Calif. Eight patients were white, and ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.76.5.566
更新日期:1979-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the extent to which a mixture of human gastric juice and enteral formula stained with two concentrations of FD&C Blue No. 1 food dye (0.8 and 1.5 mL/L) is visible in suctioned tracheobronchial secretions following three forced small-volume pulmonary aspirations over a 6-h period in an anima...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.1.276
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND AND STUDY OBJECTIVE:Phrenic nerve injury may occur after cardiac surgery; however, its cause has not been extensively investigated with electrophysiology. The purpose of this study was to determine by electrophysiologic means the importance of various possible risk factors in the development of phrenic nerve...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.1.8
更新日期:1998-01-01 00:00:00
abstract::High-frequency jet ventilation (HFJV) is FDA-approved for ventilating patients with bronchopleural fistulae (BPF), yet little is known about its effect on the fistula airleak. We quantitated a patient's BPF airleak during both conventional volume-cycled ventilation and HFJV. The effect of chest-tube suction (CTS) on B...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.1.210
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of work disability among adults with asthma and to evaluate a clinically based illness severity score as a predictor of such disability. DESIGN:Baseline and follow-up telephone interviews and medical record review. SETTING:University-based outpatient pulmonary specialty practice. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.5.1371
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Septic pulmonary embolism (SPE) is an uncommon disorder with an insidious onset and is difficult to diagnose. STUDY OBJECTIVES:To characterize the presenting features and clinical course of patients with SPE. DESIGN:Retrospective study. SETTING:Tertiary care, referral medical center. PATIENTS:Fourteen su...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.1.162
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:To elucidate the relationship of baseline glucose control and acute stimuli with hyperglycemia during medical critical illness. DESIGN:Prospective cohort study. SETTING:Medical ICU (MICU) of a university affiliated hospital. PATIENTS:Convenience sample of 100 medical patients meeting criteria for sev...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.3.879
更新日期:2004-09-01 00:00:00
abstract::Retractions of the lower ribcage (chest wall distortion [CWD]) during inspiration are frequently observed with moderate to severe respiratory disease in the infant. Laryngotracheobronchitis (LTB) results in a reversible partial airway obstruction with severe CWD. We wished to measure the motion of the chest wall durin...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.6.1842
更新日期:1993-06-01 00:00:00
abstract::Forty-three patients who had sepsis and multiple organ failure (critical illness) were studied prospectively to determine the incidence and severity of peripheral nerve function and to correlate such function with a number of variables. Electrophysiologic studies indicated a primary axonal degeneration of motor and se...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.99.1.176
更新日期:1991-01-01 00:00:00
abstract::As an aid in the differential diagnosis of exudative pleural effusions, tumor markers were investigated. We measured immunosuppressive acidic protein (IAP), carbohydrate antigen 19-9 (CA 19-9), tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), adenosine deaminase (ADA), and alpha 1-acid glycoprotein (A...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.87.3.351
更新日期:1985-03-01 00:00:00
abstract:STUDY OBJECTIVES:Acute exposure to the air in swine confinement units causes bronchial hyperresponsiveness and inflammation of the airways. This study was performed to assess the longitudinal development of bronchial responsiveness in pig farmers and to establish exposure-response relationships. METHODS:A cohort of 17...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.5.1488
更新日期:2000-05-01 00:00:00
abstract::The acute and chronic effects of fire fighting on pulmonary function were studied in 54 fire fighters from Connecticut, 32 smokers and 22 nonsmokers. Baseline studies of maximum expiratory flow-volume curves while breathing air and a mixture of 80 percent helium and 20 percent oxygen revealed obstruction of the small ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.77.3.369
更新日期:1980-03-01 00:00:00
abstract:CASE PRESENTATION:A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspne...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2017.04.168
更新日期:2017-09-01 00:00:00
abstract:STUDY OBJECTIVES:To describe the health-related quality of life (HRQL) and mental health of persons with sarcoidosis, as well as to assess physician-patient agreement about the presence of sarcoidosis symptoms. DESIGN AND SETTING:Cross-sectional study at three university medical center outpatient pulmonary clinics. P...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.3.997
更新日期:2004-03-01 00:00:00
abstract::To validate color Doppler ultrasonography of renal arteries for the assessment of renal blood flow (RBF), we compared left and right RBF estimates and their sum (total RBF) by echo-Doppler with data obtained by iodine 123-123I-p-aminohippuric acid (PAH) scintigraphy in 19 patients with heart failure and 7 normal contr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.4.912
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Linear endobronchial ultrasound (EBUS) allows real-time guidance of transbronchial needle aspiration of thoracic structures and has become an increasingly important diagnostic tool for chest physicians. Little has been published about the learning experience of operators with this technology. The purpose of ...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.13-0701
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:A multicenter study in the late 1990s demonstrated suboptimal emergency asthma care for pregnant women in US EDs. After a decade, follow-up data are lacking. We aimed to examine changes in emergency asthma care of pregnant women since the 1990s. METHODS:We combined data from four multicenter observational s...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.14-1874
更新日期:2015-02-01 00:00:00