• Shoichiro Sato, Yukako Yazawa, Ryo Itabashi, Kenichi Tsukita, Satoru Fujiwara, and Eisuke Furui.
• Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan. stshoh@gmail.com
• J. Neurol. Sci. 2011 Aug 15; 307 (1-2): 149-52.

BackgroundThe CHADS(2) score is a stroke risk stratification system for patients with atrial fibrillation (AF). The relationship between the pre-admission CHADS(2) score and stroke severity or outcome was examined in AF-related cardioembolic stroke patients.Methods423 consecutive AF-related cardioembolic stroke patients (250 men, 173 women; aged 76±10 years) were reviewed.ResultsPre-admission CHADS(2) 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 CHADS(2) and National Institutes of Health Stroke Scale (NIHSS) scores on admission, and CHADS(2) and modified Rankin scale (mRS) scores at discharge. The optimal cutoff CHADS(2) score for an mRS score ≥3 was ≥2 (sensitivity 84%, specificity 38%). For death, the optimal cutoff CHADS(2) score was ≥3 (sensitivity 59%, specificity 62%). On multivariate analysis, a CHADS(2) score ≥2 was independently associated with an mRS score ≥3 (OR 1.93, 95% CI 1.39-2.72, P<0.001), and a CHADS(2) score ≥3 was independently associated with death (OR 1.46, 95% CI 1.02-2.11, P=0.038).ConclusionsThe CHADS(2) score is related to severity and outcomes of stroke in patients with AF.Copyright © 2011 Elsevier B.V. All rights reserved.

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