CHADS Score
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CHADS Score or CHADS2 Score is an clinical prediction rule for estimating the risk of stroke in patients with atrial fibrillation (AFIB), a common and usually benign heart arrythmia. It is used to determine the degree of anticoagulation therapy required, since AFIB can cause the stasis of blood in the heart chambers, leading to the formation of a mural thrombus that can dislodge into the blood flow, reaching the brain and causing a stroke. A high CHADS score corresponds to a greater risk, and vice-versa. The CHADS/CHADS2 algorithm was validated by a cohort study published in JAMA in 2001 using 1,733 Atrial fibrillation patients tracked through Medicare claims.
Algorithm
The CHADS/CHADS2 algorithm is as follows: Risk of Stroke
According to the findings of the JAMA study, the risk of stroke as a percentage per year is:Recommendations for Anticoagulation
The following treatment strategies were recommended by the authors of theJAMA and Circulation articles:Criticism of CHADS
The main criticism of the CHADS/CHADS2 scoring system is that someone with atrial fibrillation and a previous history of stroke, but no other risk factors (i.e. CHADS2 Score = 2), is only classified as moderate risk, whereas that person is in fact at high risk of another stroke.
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