Impact of the Intelligent Scoring System Use on Clinical Practice of Outpatients With Atrial Fibrillation and Atrial Flutter and Patients Characteristics Analysis
Objectives:To assess the application effectiveness of the intelligent atrial fibrillation/flutter scoring system in the outpatient department and analyze the characteristics of patients diagnosed with atrial fibrillation/flutter.Methods:Medical records of 25 223 patients with atrial fibrillation and atrial flutter,who visited our outpatient department from August 2020 to June 2022,were collected.Characteristics of patients visited before and after the system update(September 2021)were compared.Then,404 patients,with scoring before and after system update within one year period,were selected for analysis,and the study compared the trend of score changes and the utilization of anticoagulants among these patients.Results:There was no significant change in the proportion of patients with a CHA2DS2-VASc score of male≥2 points or female≥3 points before and after the system update.However,the percentage of patients who received anticoagulation treatment increased post system update compared to the pre-update period(35.9%vs.25.2%,P＜0.001).The proportion of patients who did not receive a score without any specified reason for not scoring decreased after the system update(21.2%vs.37.9%,P＜0.001).For the 404 patients,who visited our outpatient department twice before and after the system update,it was observed that the CHA2DS2-VASc score exhibited an upward trend(2.12±1.48 vs.2.35±1.51,P=0.029).Concurrently,there was an increase in the proportion of patients with a high thrombosis risk(58.7%vs.49.5%,P=0.011),and a rise in the proportion of patients receiving anticoagulant treatment(41.4%vs.28.5%,P＜0.001).There was no significant change in the HAS-BLED score and the proportion of patients with a HAS-BLED score of≥3 points(both P＞0.05).Conclusions:The intelligent scoring system implemented in our outpatient department effectively helps doctors grasp the risk of thromboembolism and bleeding in patients with atrial fibrillation/flutter,and aids in improving the use of anticoagulants.Further optimization of the scoring process and standardization of patient evaluation and treatment are needed.
outpatient serviceCHA2DS2-VASc scoreHAS-BLED scoreelectronic health records
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NSTL
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