Use of CHADS2 and CHA2DS2-VASc scores to predict prognosis after stroke

Introduction. - Stroke is one of the most devastating neurological disorders. Currently, we don't have an ideal score that predicts the prognosis of stroke patients. The CHADS(2) and CHA(2)DS(2)-VASc scores are well-validated tools for the estimation of stroke risk in patients with atrial fibrillation. The purpose of this study was to investigate if these scores can predict the outcomes of all the patients who suffered an ischemic stroke regardless of atrial fibrillation. Methods. - Consecutive patients that were admitted with an acute ischemic stroke were classified into subgroups according to pre-stroke CHADS(2) and CHA(2)DS(2)-VASc scores and after 2 years the functional outcome, stroke recurrence, major cardiovascular events and mortality were assessed. Results. - Among the 973 patients that were included in analysis, the mean age was 56.7 (SD 15.7) and 46.6% were female. There were 226 (23.2%), 365 (37.5%) and 382 (39.3%) patients with low, intermediate and high CHADS(2) score, respectively. For CHADS(2)-VASc score there were 81 (8.3%), 268 (27.6%), and 624 (64.1%) patients with low, intermediate and high, respectively. Both high-risk scores were associated with middle-term poor functional outcome, stroke recurrence, major cardiovascular events and all-cause mortality. CHADS(2) and CHA(2)DS(2)-VASc scores presented a high sensitivity and a high negative predictive value. CHA(2)DS(2)-VASc was more sensitive than CHADS(2) score. Conclusion. - CHADS(2) and CHA(2)DS(2)-VASc scores were both associated with stroke outcomes regardless of atrial fibrillation. These scores can be useful tools for the prognosis stratification of a patient with an ischemic stroke. (C) 2019 Elsevier Masson SAS. All rights reserved.