Wednesday, March 4, 2009

Who is Chad anyways?

Atrial Fibrillation. And the CHADS2 score. What's the deal?

Well, essentially this is a very simple scoring system to determine your patients risk of thromboembolism with atrial fibrillation.

  • Congestive heart failure (any history): 1 point
  • Hypertension (including prior history): 1 point
  • Age > 75: 1 point
  • Diabetes mellitus: 1 point
  • Stroke: 2 points
Simple as that. Add up the points. A higher number of points means that the risk of thromboembolism is more likely. Low risk patients have a score of 0 - 1, where the annual incidence of stroke is less than 2.5%. A score of 2 carries a Moderate risk (4% per year) of stroke, and anything greater than 2 is High risk.

Essentially, Aspirin can be used to treat low risk patients, Aspirin or Warfarin in moderate risk patients, and Warfarin in high risk patients. Warfarin will reduce the risk of embolic stroke by about 2/3.

Here is a link to the original article published in JAMA in 2001

No comments:

Post a Comment