The Use of CHA2DS2-VASc Score to Predict Functional Outcomes of Mechanical Thrombectomy

Abstract

Background: Mechanical thrombectomy is widely used for revascularization of acute ischemic strokes from large vessel occlusions. Functional outcomes following mechanical thrombectomy are typically assessed using the modified Rankin scale. CHA2DS2-VASc score is commonly used to estimate the stroke risk of patients with atrial fibrillation, but studies have verified its use in other various situations. Our study aimed to assess the utility of CHA2DS2-VASc score in predicting outcomes of patients undergoing mechanical thrombectomy. Methods: We performed a single center retrospective study. Of patients with acute ischemic stroke who underwent mechanical thrombectomy for large vessel occlusion (n = 448). CHA2DS2-VASc score was calculated on each patient and the study population was grouped based on low-risk ≤ 2, intermediate risk 3-4 and high-risk ≥ 5. Association between CHA2DS2-VASc score and 90-day modified Rankin score as well as in-hospital, 30-day, and 1-year mortality was evaluated and compared between the three groups. Results: A total of 312 patients met criteria for the study. Patients in the high-risk CHA2DS2-VASc score had a significantly higher modified Rankin score (4.48) when compared to low (2.57) and intermediate (3.82) risk groups. Higher CHA2DS2-VASc scores were also associated with a significantly higher in-hospital, 30-day, and one year mortality. Conclusion: CHA2DS2-VASc score, a simple bed-side tool, can predict higher mortality and worse functional outcomes in acute ischemic stroke patients undergoing mechanical thrombectomy for large vessel occlusions.