Recent history of congestive heart failure | Yes No |
Hypertension | Yes No |
Age >= 75 years | <75 years >= 75 years |
Diabetes Mellitus | Yes No |
History of stroke or TIA | Yes No |
The CHADS
2
(CHF, Hypertension, Age, Diabetes, Stroke) score was developed for estimation of the stroke risk in patients with atrial fibrillation.
The CHADS
2
score helps to classify patients into high risk and low risk for stroke and allow appropriate level of anticoagulation to be advised.
5 items make up this CHADS 2 Score, with the CHADS 2 Score being the sum of all items (range 0-6 points). The higher the score, the higher the risk of stroke, if no anticoagulation is provided.
It should also be pointed out that this score performs better than the AFI and SPAF methods; but does not consider other risks which may increase stroke risk (e.g. valvular heart disease, carotid stenosis, etc).
Elements of the CHADS 2 Score
*Transient Ischemic Attack
Interpretation:
CHADS2 Score | Stroke risk per 100 pt-yrs (%) | CHADS2 risk level | Warfarin Recommended |
---|---|---|---|
0 | 1.9 | low | No |
1 | 2.8 | low | No |
2 | 4.0 | Moderate | Yes |
3 | 5.9 | Moderate | Yes |
4 | 8.5 | High | Yes |
5 | 12.5 | High | Yes |
6 | 18.2 | High | Yes |
References:
Fitzgerald BT, Cohn SL, Klein AL. Stroke prevention in atrial fibrillation: current anticoagulation management and future directions. Cleve Clin J Med. 2005;72 Suppl 1:S24-30.
Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864-70.