Pre-admission CHADS2 score is related to severity and outcome of stroke

Abstract: Background: The CHADS2 score is a stroke risk stratification system for patients with atrial fibrillation (AF). The relationship between the pre-admission CHADS2 score and stroke severity or outcome was examined in AF-related cardioembolic stroke patients. Methods: 423 consecutive AF-related cardioembolic stroke patients (250 men, 173 women; aged 76±10years) were reviewed. Results: Pre-admission CHADS2 scores of 0, 1, 2, 3, 4, 5, and 6 were present in 4.3%, 21.0%, 34.3%, 23.6%, 11.8%, 4.5%, and 0.5% of patients, respectively. There were significant correlations (P<0.001) between CHADS2 and National Institutes of Health Stroke Scale (NIHSS) scores on admission, and CHADS2 and modified Rankin scale (mRS) scores at discharge. The optimal cutoff CHADS2 score for an mRS score ≥3 was ≥2 (sensitivity 84%, specificity 38%). For death, the optimal cutoff CHADS2 score was ≥3 (sensitivity 59%, specificity 62%). On multivariate analysis, a CHADS2 score ≥2 was independently associated with an mRS score ≥3 (OR 1.93, 95% CI 1.39–2.72, P<0.001), and a CHADS2 score ≥3 was independently associated with death (OR 1.46, 95% CI 1.02–2.11, P=0.038). Conclusions: The CHADS2 score is related to severity and outcomes of stroke in patients with AF. [Copyright &y& Elsevier]