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Updated: Mar 29, 2026
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Published on: January 7, 2019
CHADS2 scores as a predictor of ischemic stroke after radical prostatectomy
Yu-Wan Yang1,2, Shang-Sen Lee3,4, Chi-Cheng Chen3,4
1Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
Insights
The CHADS2 score effectively predicts ischemic stroke risk in prostate cancer patients undergoing radical prostatectomy, outperforming the Charlson Comorbidity Index Score (CCIS). Higher CHADS2 scores indicate significantly elevated stroke risk, warranting cardiovascular risk management.
Area of Science:
- Cardiovascular Medicine
- Oncology
- Epidemiology
Background:
- Prostate cancer patients face elevated stroke risk, influenced by age and comorbidities.
- The Charlson Comorbidity Index Score (CCIS) is a standard for risk adjustment in healthcare data.
- Predictive models for stroke risk in prostate cancer patients require validation.
Purpose of the Study:
- To evaluate the predictive accuracy of CHADS2 scores and CCIS for ischemic stroke in prostate cancer patients.
- To compare the performance of CHADS2 scores versus CCIS in stratifying 5-year ischemic stroke risk.
Main Methods:
- Utilized Taiwan's National Health Insurance Research Database (NHIRD) for patient data.
- Included 5414 non-atrial fibrillation (AF) prostate cancer patients who had radical prostatectomy (1997-2011).
- Assessed 5-year ischemic stroke risk using CHADS2 scores and CCIS, with follow-up until stroke, death, or study end.
Main Results:
- The overall 5-year ischemic stroke risk was 1.7%.
- CHADS2 score demonstrated strong predictive correlation (AUC = 0.978) with ischemic stroke risk (0.02% for scores 0-1, 13.9% for 2-3, 44.4% for ≥4).
- CCIS showed weaker correlation (AUC = 0.520) with ischemic stroke risk (1.6% for scores 0-1, 1.7% for 2-3, 3.8% for ≥4).
Conclusions:
- The CHADS2 score is a valuable tool for predicting ischemic stroke in prostate cancer patients post-radical prostatectomy.
- Patients with higher CHADS2 scores exhibit significantly increased ischemic stroke risk.
- Prostate cancer patients with elevated CHADS2 scores require focused cardiovascular risk evaluation and management.
Abstract:
Patients with prostate cancer have an increased risk of stroke, but their absolute rate of stroke depends on age and comorbid conditions. The Charlson Comorbidity Index Score (CCIS) is a widely accepted measure for risk adjustment in administrative claims data sets. This study assesses the predictive value of CHADS2 scores and CCIS for stroke among patients with prostate cancer. The study was conducted based on data taken from Taiwan's National Health Insurance Research Database (NHIRD). We identified a total of 5414 participants with nonatrial fibrillation (AF) prostate cancer diagnoses who underwent radical prostatectomy between 1997 and 2011. CHADS2 scores and CCIS were used to stratify the 5-year ischemic stroke risk. All participants were followed from the date of enrollment until ischemic stroke, death, or the end of the 5-year follow-up period. The 5-year risk of ischemic stroke in the present study was 1.7%. Ischemic stroke has a better correlation with CHADS2 (CHADS2 score = 0 to 1: 0.02%, CHADS2 score = 2 to 3: 13.9%, CHADS2 score ≥ 4: 44.4%; AUC = 0.978) than CCIS (CCIS = 0 to 1: 1.6%, CCIS = 2 to 3: 1.7%, CCIS ≥ 4: 3.8%; AUC = 0.520). Our results show that patients with prostate cancer who underwent radical prostatectomy show significantly higher risk of ischemic stroke in high CHADS2 score patients, and the CHADS2 score could be applied for ischemic stroke prediction. Cardiovascular risks evaluation and management are suggested for prostate cancer patients with higher CHADS2 score.
