高 CHA2DS2-VASc 评分（充血性心力衰竭、高血压、年龄 > 75 岁、糖尿病、既往中风或短暂性脑缺血发作或血栓栓塞、血管疾病、年龄 65-74 岁和性别类别）与不同环境中的不良临床结果相关。本研究的目的是评估 CHA2DS2-VASc 评分和 R2CHA2DS2-VASc 评分（包括肾功能损害）与内科病房住院患者的院内死亡率和住院时间长度之间的关联。我们连续招募了 983 名患者在内科病房住院 3 年的患者。 R2CHA2DS2-VASc 评分的计算方法是，根据 K-DOQI 定义，是否存在慢性肾病 (CKD)，在 CHA2DS2-VASc 上加 2 分。主要结局是全因死亡率和住院时间 > 10 天的综合结果。 CKD 3-5 期患者的 CHA2DS2-VASc 与 1-2 期相比有所增加 (p< 0.001)。 47.3% 的住院患者出现复合结局。根据传染病和癌症的存在进行调整的多变量线性逻辑回归分析，以及复合结果的发生显示，CHA2DS2-VASc 和 R2CHA2DS2 的调整 OR 分别为 1.349 (95% CI 1.248-1.462) 和 1.254 (95% CI 1.179-1.336) -分别为 VASc 分数。 CHA2DS2-VASc 和 R2CHA2DS2-VASc 评分与综合结果之间的关联没有发现差异（AUC 0.631 vs 0.630），此外，将住院期间是否存在传染病以及阳性癌症病史添加到模型中会增加 AUC （0.667 和 0.663）。无论是否存在 CKD，CHA2DS2-VASc 评分越高，与内科病房住院患者的住院时间和死亡率增加相关。© 2023。作者。

High CHA2DS2-VASc score (Congestive heart failure, Hypertension, Age > 75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65-74 and Sex category) was associated with adverse clinical outcomes in different settings. The aim of the present study was to evaluate the association between CHA2DS2-VASc score and R2CHA2DS2-VASc score (which includes renal impairment) with in-hospital mortality and length of hospital stay in patients hospitalized in an internal medicine ward.We enrolled 983 consecutive patients admitted during 3 years in an internal medicine ward. R2CHA2DS2-VASc score was calculated by adding 2 points to CHA2DS2-VASc for the presence of chronic kidney disease (CKD), defined according to K-DOQI. The primary outcome was a composite of all-cause mortality and length of hospital stay > 10 days.Patients with CKD stages 3-5 presented with increased CHA2DS2-VASc vs stages 1-2 (p < 0.001). The composite outcome occurred in 47.3% of inpatients. Multivariable linear logistic regression analyses adjusted for presence of infectious diseases and cancer, with the occurrence of composite outcome showed an adjusted OR of 1.349 (95% CI 1.248-1.462) and 1.254 (95% CI 1.179-1.336) for CHA2DS2-VASc and R2CHA2DS2-VASc scores, respectively. No differences were found in the association between CHA2DS2-VASc and R2CHA2DS2-VASc scores with the composite outcome (AUC 0.631 vs 0.630), and furthermore, adding the presence/absence of infectious diseases during hospitalization and positive cancer history to the models increased the AUC (0.667 and 0.663).Incrementally higher CHA2DS2-VASc score is associated with increased length of hospital stay and mortality in patients hospitalized in an internal medicine ward, regardless of the presence of CKD.© 2023. The Author(s).