Migotanie przedsionków – ryzyko udaru mózgu

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Index CHADS2

CHADS2 Kryteria Punkty
Cardiac Failure (niewydolność krążenia) 1
Hypertension (nadciśnienie) 1
Age (wiek) 1
Diabetes (cukrzyca) 1
Stroke (przebyty udar lub TIA) 2

Ryzyko Udaru w skali CHADS2 (w % na rok)

0 punktów —> 1,9 (95% CI: 1,2 – 3,0)
1 punkt —> 2,8 (95% CI: 2,0 – 3,8)
2 punkty —> 4,0 (95% CI: 3,1 – 5,1)
3 punkty —> 5,9 (95% CI: 4,6 – 7,3)
4 punkty —> 8,5 (95% CI: 6,3 – 11,1)
5 punktów —> 12,5 (95% CI: 8,2 – 17,5)
6 punktów —> 18,2 (95% CI: 10,5 – 27,4)

A therapeutic bleeding risk stratification score for those on oral anticoagulants in atrial fibrillation[1]. It is matched to the CHA2DS2-VASc score used for stroke risk stratification but has not as of 2010 been externally validated.
HAS-BLED score for bleeding risk on oral anticoagulation in atrial fibrillation Feature Score if present

Hypertension (Systolic ≥ 160mmHg) 1
Abnormal renal function 1
Abnormal liver function 1
Age ≥ 65 years 1
Stroke in past 1
Bleeding 1
Labile INRs 1
Taking other drugs as well 1
Alcohol intake at same time 1

A score of 3 or more indicates increased one year bleed risk on anticoagulation sufficient to justify caution or more regular review. The risk is for intracranial bleed, bleed requiring hospitalization or a haemoglobin drop > 2g/L or that needs transfusion.

Patrz: dak

Bibliography

JAMA 2001:285:2864-2870, Arch Intern Med. 2003:163:936-043 : full source reference Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest. 2010 Mar 18.(Epub ahead of print) (Link to article – subscription may be required.)