A Vascular Complications Risk (VASCOR) score for patients undergoing invasive cardiac procedures in the catheterization laboratory setting: A prospective cohort study.

BACKGROUND: Vascular complications are still common in the catheterization laboratory setting. However, no risk scores for their prediction have been described. With a view to bridging this gap, the present study sought to develop and validate a score for prediction of vascular complications associated with arterial access in patients undergoing interventional cardiology procedures. METHODS: This prospective multicenter cohort study included adult patients who underwent cardiac catheterization via the femoral or radial route. The outcomes of interest were: access site hematoma; major and minor bleeding; and retroperitoneal hemorrhage, pseudoaneurysm, or arteriovenous fistula requiring surgical repair. Past medical history as well as pre-procedural, intra-procedural, and post-procedural variables were collected. Patients were randomly allocated to the derivation or validation cohorts at a 2:1 ratio. The following equation constituted the score: (>6F introducer sheath×4.0)+(percutaneous coronary intervention×2.5)+(history of vascular complication after prior interventional cardiology procedure×2.0)+(prior use of warfarin or phenprocoumon×2.0)+(female sex×1.5)+(age⩾60 years×1.5). The maximum score is 13.5 points. RESULTS: A score dichotomized at ⩾3 (best cutoff for balancing sensitivity and specificity) was moderately accurate (sensitivity=0.66 (95% confidence interval: 0.59-0.73); specificity=0.59 (95% confidence interval: 0.56-0.61)). Patients with a score ⩾3 were at increased risk of complications (odds ratio: 2.95; 95% confidence interval: 2.22-3.91). CONCLUSIONS: This study yielded a score that is capable of predicting vascular complications and easily applied in daily practice by providers working in the catheterization laboratory setting.

Validity and reliability of the dietary sodium restriction questionnaire in patients with hypertension.

The study aimed to evaluate the reliability and the validity of the dietary sodium restriction questionnaire (DSRQ) in patients with hypertension receiving outpatient treatment at a tertiary care university hospital in Southern Brazil. This instrument is composed of three subscales: attitude, subjective norm and perceived behavioral control. A total of 104 patients were included. They were 63.3±8.9 years old and 75% were females. Cronbach's alpha coefficient for the subscales of attitude, subjective norm and perceived behavioral control were 0.75, 0.37 and 0.82, respectively. The PCA with the extraction of three factors explained a total of 53.5% of the variance. The data suggest that the 15-item DSRQ is reliable and has internal consistency of its construct to measure the barriers and the attitudes of hypertensive patients related to dietary sodium restriction and may be useful to improve blood pressure control.