NGHIÊN CỨU ĐẶC ĐIỂM VÀ VAI TRÒ CỦA CHỈ SỐ BỆNH KÈM TRONG ĐIỀU TRỊ CHỐNG HUYẾT KHỐI DỰA VÀO THANG ĐIỂM HAS-BLED Ở BỆNH NHÂN CAO TUỔI CÓ RUNG NHĨ TẠI BỆNH VIỆN ĐA KHOA THÀNH PHỐ CẦN THƠ VÀ BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ

Abstract

Background: Charlson Comorbidity Index is used to be evaluated comorbidity burden in older patients with atrial fibrillation which associates with some factors such as bleeding risk, dosage of acenocoumarol and antiplatelet drug as a combination therapy. Objectives: Study on the characteristics and values of Charlson Comorbidity Index on antithrombotic therapy based on HAS-BLED score in older patients with atrial fibrillation. Materials and methods: A descriptive crosssectional study of 167 older patients with atrial fibrillation at Can Tho City General Hospital and Can Tho Central General Hospital from 2022 to 2024. Results: The most common comorbidity was congrestive heart failure (58.7%). There was a positive correlation between Charlson Comorbidity Index and high bleeding risk (HAS-BLED≥3) with Correlation coefficient (r)=0.35 (p<0.001). The results of a multivariate logistic regression analysis showed that Charlson Comorbidity Index≥2 led to increase about 24 times of antiplatelet prescription (p=0.001) while decreased about 1.5 times of acenocoumarol dose compared to standard dose (p<0.001). Conclusions: Congrestive heart failure was the most common comorbidity in older patients with atrial fibrillation. Charlson Comorbidity Index≥2 predicted increased antiplatelet prescription and high bleeding risk. When Charlson Comorbidity Index≥2, it was necessary to use low acenocoumarol dose compared to standard dose while maintained antiplatelet dose in order to treat multimorbidity.