title: Pre-admission CHADS2 score is related to severity and outcome of stroke.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  423 consecutive AF-related cardioembolic stroke patients (250 men, 173 women; aged 76±10 years) were reviewed.
  
  
  RESULTS
  Pre-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).
  
  
  CONCLUSIONS
  The CHADS(2) score is related to severity and outcomes of stroke in patients with AF.
authors.affiliation: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan. stshoh@gmail.com
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.forename: Yukako
authors.initials: Y
authors.lastname: Yazawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Itabashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tsukita
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Eisuke
authors.initials: E
authors.lastname: Furui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality; D015897:Comorbidity / Q000639:trends; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality; D013923:Thromboembolism / Q000175:diagnosis* / Q000401:mortality