CHADS2 and CHA2DS2-VASc Risk Stratification Systems for Stroke Risk in Atrial Fibrillation: Evaluation of Their Correlation to In-Hospital Clinical Outcomes

Abstract

CHADS2 scoring is the most widely used stratification to assess stroke risk in AF patients. Recently, CHA2DS2-VASc scoring has been introduced. We evaluated the correlation of these scoring systems to in-hospital clinical outcomes. This is a retrospective study of patients with acute AF admitted to the Critical Care (CCU) or Telemetry Unit at The Medical City. Out of 154 patients, 60 were admitted either at the CCU or Telemetry. CHADS2 and CHA2DS2-VASc scores were compared with in-hospital clinical outcomes: primary end-points include conversion to sinus rhythm within 24 h and length of hospital stay; secondary end-points include in-hospital mortality and thromboembolic event. Mean age was 59.53±17.98 years, 26 (43.3%) males. Majority were diabetic and hypertensive. The mean CHADS2 score was 1.26±1.031 while the mean CHA2DS2-VASc score was 2.25±1.65. There was no correlation between conversion of AF to sinus rhythm in less than 24 h, regardless of the CHADS2 score and medications given. Patients with CHADS2 score 2 (P0.032). Likewise, those with CHA2DS2-VASc 2 (P0.022). Discharge disposition did not vary significantly in the three risk groups. CHADS2 and CHA2DS2-VASc scores correlate with longer hospital stay in acute AF patients when the scores are >2. Both scores did not correlate with other end-points.