Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores on severity and functional outcome in acute ischemic stroke with atrial fibrillation

Koji Tanaka, Takeshi Yamada, Takako Torii, Konosuke Furuta, Shoji Matsumoto, Takeo Yoshimura, Kei Ichiro Takase, Yoshifumi Wakata, Naoki Nakashima, Jun Ichi Kira, Hiroyuki Murai

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background We examined the association between pre-admission risk scores and severity on admission and functional outcome in acute ischemic stroke with atrial fibrillation (AF). Methods Between September 2011 and April 2014, we retrospectively extracted consecutive ischemic stroke patients with AF whose pre-admission modified Rankin Scale (mRS) score was 2 or less from our prospective database. Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were calculated in each patient, and their association with the National Institutes of Health Stroke Scale (NIHSS) score on admission or unfavorable outcome (mRS ≥3 at 3 months from the onset) was assessed. Results A total of 344 patients (189 were men; age, 77.7 ± 10.0 years) were included in the analysis. The median pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were 2, 4, and 4, respectively. NIHSS score on admission was positively correlated with pre-admission CHADS2 (ρ =.116, P =.031), CHA2DS2-VASc (ρ =.166, P =.020), and R2CHADS2 scores (ρ =.106, P =.049). Receiver operating characteristic (ROC) curve analysis revealed that pre-admission CHADS2 score of 2 or more (sensitivity, 80%; specificity, 45%; area under the ROC curve [AUC],.654), CHA2DS2-VASc score of 3 or more (sensitivity, 86%; specificity, 44%; AUC,.683), and R2CHADS2 score of 4 or more (sensitivity, 61%; specificity, 62%; AUC,.657) were associated with unfavorable outcome. The pre-admission CHA2DS2-VASc score was better than the pre-admission CHADS2 score in estimating unfavorable outcome (P =.017). In multivariate analysis, cutoffs of these scores, female sex, higher NIHSS score, and internal carotid artery occlusion were associated with unfavorable outcome. Conclusions Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were associated with onset severity and functional outcome in acute ischemic stroke with AF.

Original languageEnglish
Pages (from-to)1629-1635
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Atrial Fibrillation
Stroke
ROC Curve
National Institutes of Health (U.S.)
Area Under Curve
Internal Carotid Artery
Multivariate Analysis
Databases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores on severity and functional outcome in acute ischemic stroke with atrial fibrillation. / Tanaka, Koji; Yamada, Takeshi; Torii, Takako; Furuta, Konosuke; Matsumoto, Shoji; Yoshimura, Takeo; Takase, Kei Ichiro; Wakata, Yoshifumi; Nakashima, Naoki; Kira, Jun Ichi; Murai, Hiroyuki.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 24, No. 7, 01.07.2015, p. 1629-1635.

Research output: Contribution to journalArticle

Tanaka, Koji ; Yamada, Takeshi ; Torii, Takako ; Furuta, Konosuke ; Matsumoto, Shoji ; Yoshimura, Takeo ; Takase, Kei Ichiro ; Wakata, Yoshifumi ; Nakashima, Naoki ; Kira, Jun Ichi ; Murai, Hiroyuki. / Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores on severity and functional outcome in acute ischemic stroke with atrial fibrillation. In: Journal of Stroke and Cerebrovascular Diseases. 2015 ; Vol. 24, No. 7. pp. 1629-1635.
@article{23d4d3565b1949d7883dc197ac375a65,
title = "Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores on severity and functional outcome in acute ischemic stroke with atrial fibrillation",
abstract = "Background We examined the association between pre-admission risk scores and severity on admission and functional outcome in acute ischemic stroke with atrial fibrillation (AF). Methods Between September 2011 and April 2014, we retrospectively extracted consecutive ischemic stroke patients with AF whose pre-admission modified Rankin Scale (mRS) score was 2 or less from our prospective database. Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were calculated in each patient, and their association with the National Institutes of Health Stroke Scale (NIHSS) score on admission or unfavorable outcome (mRS ≥3 at 3 months from the onset) was assessed. Results A total of 344 patients (189 were men; age, 77.7 ± 10.0 years) were included in the analysis. The median pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were 2, 4, and 4, respectively. NIHSS score on admission was positively correlated with pre-admission CHADS2 (ρ =.116, P =.031), CHA2DS2-VASc (ρ =.166, P =.020), and R2CHADS2 scores (ρ =.106, P =.049). Receiver operating characteristic (ROC) curve analysis revealed that pre-admission CHADS2 score of 2 or more (sensitivity, 80{\%}; specificity, 45{\%}; area under the ROC curve [AUC],.654), CHA2DS2-VASc score of 3 or more (sensitivity, 86{\%}; specificity, 44{\%}; AUC,.683), and R2CHADS2 score of 4 or more (sensitivity, 61{\%}; specificity, 62{\%}; AUC,.657) were associated with unfavorable outcome. The pre-admission CHA2DS2-VASc score was better than the pre-admission CHADS2 score in estimating unfavorable outcome (P =.017). In multivariate analysis, cutoffs of these scores, female sex, higher NIHSS score, and internal carotid artery occlusion were associated with unfavorable outcome. Conclusions Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were associated with onset severity and functional outcome in acute ischemic stroke with AF.",
author = "Koji Tanaka and Takeshi Yamada and Takako Torii and Konosuke Furuta and Shoji Matsumoto and Takeo Yoshimura and Takase, {Kei Ichiro} and Yoshifumi Wakata and Naoki Nakashima and Kira, {Jun Ichi} and Hiroyuki Murai",
year = "2015",
month = "7",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2015.03.036",
language = "English",
volume = "24",
pages = "1629--1635",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores on severity and functional outcome in acute ischemic stroke with atrial fibrillation

AU - Tanaka, Koji

AU - Yamada, Takeshi

AU - Torii, Takako

AU - Furuta, Konosuke

AU - Matsumoto, Shoji

AU - Yoshimura, Takeo

AU - Takase, Kei Ichiro

AU - Wakata, Yoshifumi

AU - Nakashima, Naoki

AU - Kira, Jun Ichi

AU - Murai, Hiroyuki

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Background We examined the association between pre-admission risk scores and severity on admission and functional outcome in acute ischemic stroke with atrial fibrillation (AF). Methods Between September 2011 and April 2014, we retrospectively extracted consecutive ischemic stroke patients with AF whose pre-admission modified Rankin Scale (mRS) score was 2 or less from our prospective database. Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were calculated in each patient, and their association with the National Institutes of Health Stroke Scale (NIHSS) score on admission or unfavorable outcome (mRS ≥3 at 3 months from the onset) was assessed. Results A total of 344 patients (189 were men; age, 77.7 ± 10.0 years) were included in the analysis. The median pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were 2, 4, and 4, respectively. NIHSS score on admission was positively correlated with pre-admission CHADS2 (ρ =.116, P =.031), CHA2DS2-VASc (ρ =.166, P =.020), and R2CHADS2 scores (ρ =.106, P =.049). Receiver operating characteristic (ROC) curve analysis revealed that pre-admission CHADS2 score of 2 or more (sensitivity, 80%; specificity, 45%; area under the ROC curve [AUC],.654), CHA2DS2-VASc score of 3 or more (sensitivity, 86%; specificity, 44%; AUC,.683), and R2CHADS2 score of 4 or more (sensitivity, 61%; specificity, 62%; AUC,.657) were associated with unfavorable outcome. The pre-admission CHA2DS2-VASc score was better than the pre-admission CHADS2 score in estimating unfavorable outcome (P =.017). In multivariate analysis, cutoffs of these scores, female sex, higher NIHSS score, and internal carotid artery occlusion were associated with unfavorable outcome. Conclusions Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were associated with onset severity and functional outcome in acute ischemic stroke with AF.

AB - Background We examined the association between pre-admission risk scores and severity on admission and functional outcome in acute ischemic stroke with atrial fibrillation (AF). Methods Between September 2011 and April 2014, we retrospectively extracted consecutive ischemic stroke patients with AF whose pre-admission modified Rankin Scale (mRS) score was 2 or less from our prospective database. Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were calculated in each patient, and their association with the National Institutes of Health Stroke Scale (NIHSS) score on admission or unfavorable outcome (mRS ≥3 at 3 months from the onset) was assessed. Results A total of 344 patients (189 were men; age, 77.7 ± 10.0 years) were included in the analysis. The median pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were 2, 4, and 4, respectively. NIHSS score on admission was positively correlated with pre-admission CHADS2 (ρ =.116, P =.031), CHA2DS2-VASc (ρ =.166, P =.020), and R2CHADS2 scores (ρ =.106, P =.049). Receiver operating characteristic (ROC) curve analysis revealed that pre-admission CHADS2 score of 2 or more (sensitivity, 80%; specificity, 45%; area under the ROC curve [AUC],.654), CHA2DS2-VASc score of 3 or more (sensitivity, 86%; specificity, 44%; AUC,.683), and R2CHADS2 score of 4 or more (sensitivity, 61%; specificity, 62%; AUC,.657) were associated with unfavorable outcome. The pre-admission CHA2DS2-VASc score was better than the pre-admission CHADS2 score in estimating unfavorable outcome (P =.017). In multivariate analysis, cutoffs of these scores, female sex, higher NIHSS score, and internal carotid artery occlusion were associated with unfavorable outcome. Conclusions Pre-admission CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were associated with onset severity and functional outcome in acute ischemic stroke with AF.

UR - http://www.scopus.com/inward/record.url?scp=84930820896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930820896&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2015.03.036

DO - 10.1016/j.jstrokecerebrovasdis.2015.03.036

M3 - Article

C2 - 25906940

AN - SCOPUS:84930820896

VL - 24

SP - 1629

EP - 1635

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 7

ER -