Vol. 40 | No. 2 | July-December 2012 Back

Open Access

The CHADS2 and CHA2DS2 VASC Risk Stratification Systems for Stroke Risk in Atrial Fibrillation: Evaluation of their Correlation to In-hospital Clinical Outcomes

Rachel Rose A. Orteza-del Rosario, Katherine Z. Cosca, Raul E. Ramboyong, Marcellus Francis L. Ramirez
Dec 2012 DOI 10.69944/pjc.dea209d88d

Abstract

The CHADS2 scoring system is the most widely used risk stratification method to assess stroke risk in atrial fibrillation (AF) patients. Recently, a CHA2DS2VASC scoring modification has been introduced. This is a retrospective study of patients diagnosed to have acute onset AF admitted to the critical care unit or telemetry unit at The Medical City. Sixty patients were included in the study. CHADS2 and CHA2DS2VASC scores were calculated for each patient and correlated with in-hospital clinical outcomes of the patients: primary end-points included conversion to sinus rhythm within 24 hours and length of hospital stay, while secondary end points included in-hospital outcome, and length of hospital stay. The mean age was 59.53 ± 17.98 years, Majority of the subjects were diabetic and hypertensive. The mean CHADS2 score was 1.26 ± 1.031 while the mean CHA2DS2VASC score was 2.25 ± 1.65. Only one patient expired. Two remained in AF on discharge. There was no significant difference in conversion of AF to sinus rhythm in less than 24 hours among patients with CHADS2 score of <2, 2 and > 2, regardless of the medications given (p=0.067). Patients with a CHADS2 score <2 had a shorter hospital stay compared to those with CHADS2 score >2 (2.79 ± 2.26 days vs 4.71 ± 3.45 days, P 0.032). Those with CHA2DS2VASC score <2 had a significantly shorter hospital stay than the group with score of > 2 (2.5 ± 1.60 days vs 3.65 ± 2.93 days; p=0.022). Discharge disposition did not significantly vary in the three risk groups. The added length of hospital stay in the higher risk group was not associated with anticoagulant initiation and bleeding parameters monitoring.

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