The Prognostic Value of the CHA2DS2-VASc Score for Predicting In-Hospital Mortality and Short-Term Outcomes in Patients with Acute Ischemic Stroke

CHA2DS2-VASc评分在预测急性缺血性卒中患者院内死亡率和短期预后中的预后价值

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Abstract

INTRODUCTION: Acute ischemic stroke (AIS) is a common fatal neurological disease worldwide. This study aimed to investigate the prognostic value of the CHA2DS2-VASc score in patients with AIS. METHODS: Two hundred and fifty patients admitted to the emergency department with a diagnosis of AIS without AF were prospectively enrolled in the study. RESULTS: The CHA2DS2-VASc score, NIHSS score, initial stroke severity (ISS), cerebral infarct volume (CIV), and modified Rankin Scale (mRS) were significantly higher, whereas left ventricular ejection fraction (LVEF) and Barthell index (BI) were significantly lower in the in-hospital mortality (+) group. There was a statistically significant positive correlation of the CHA2DS2-VASc score with NIHSS score (r=0.389; p<0.001), ISS (r=0.417; p<0.001), mRS (r=0.362; p<0.001) and SIV (r=0.214; p<0.001) whereas a significant negative correlation of the CHA2DS2-VASc score with BI (r= -0.371; p<0.001). In multivariable Cox-regression analysis, we found that the CHA2DS2-VASc score (HR: 1.816; 95% CI: 1.209-2.726; p<0.001), congestive heart failure, NIHSS score, and BI were independent predictors of in-hospital mortality. Finally, in the Kaplan-Meier survival analysis, in-hospital mortality was significantly higher in patients with the CHA2DS2-VASc score ≥6 (log-rank p<0.001). CONCLUSION: The CHA2DS2-VASc score was established to be an independent predictor of in-hospital mortality and short-term outcomes in AIS patients without AF.

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