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Updated: Aug 25, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Functional Outcomes in Acute
Hyung Jun Kim1, Moo-Seok Park1, Joonsang Yoo2
1Department of Neurology, Seoul Hospital, College of Medicine, Ewha Woman's University, Seoul 07804, Korea.
Insights
The CHADS2 and ATRIA stroke risk scores can predict unfavorable outcomes in patients undergoing endovascular thrombectomy (EVT). Higher scores indicate a greater risk of poor outcomes after EVT.
Area of Science:
- Neurology
- Cardiology
- Interventional Radiology
Background:
- Stroke risk scores like CHADS2, CHA2DS2-VASc, ATRIA, and Essen are used to assess thromboembolism risk.
- Endovascular thrombectomy (EVT) is a critical reperfusion therapy for stroke.
- Predicting outcomes after EVT is essential for patient selection and management.
Purpose of the Study:
- To investigate the association between pre-admission stroke risk scores and unfavorable outcomes in patients treated with EVT.
- To determine if existing stroke risk scores can predict outcomes following EVT.
Main Methods:
- Utilized data from a nationwide, multicenter registry of patients who underwent EVT.
- Calculated CHADS2, CHA2DS2-VASc, ATRIA, and Essen scores pre-admission for 404 patients.
- Correlated these scores with 3-month modified Rankin Scale (mRS) outcomes.
Main Results:
- 213 (52.7%) of 404 EVT patients experienced unfavorable outcomes (mRS 3-6).
- All assessed stroke risk scores were significantly higher in patients with unfavorable outcomes.
- Multivariable analysis confirmed CHADS2 (OR 1.484) and ATRIA (OR 1.128) scores positively correlated with unfavorable outcomes.
Conclusions:
- The CHADS2 and ATRIA stroke risk scores are significant predictors of unfavorable outcomes in EVT patients.
- These scores may aid in identifying patients at higher risk for poor functional status after EVT.
- Further validation of CHADS2 and ATRIA scores for EVT patient stratification is warranted.
Abstract:
Background: CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores are used to estimate thromboembolism risk. We aimed to investigate the association between unfavorable outcomes and stroke risk scores in patients who received endovascular thrombectomy (EVT). Methods: This study was performed using data from a nationwide, multicenter registry to explore the selection criteria for patients who would benefit from reperfusion therapies. We calculated pre-admission CHADS2, CHA2DS2-VASc, ATRIA, and Essen scores for each patient who received EVT and compared the relationship between these scores and 3-month modified Rankin Scale (mRS) records. Results: Among the 404 patients who received EVT, 213 (52.7%) patients had unfavorable outcomes (mRS 3−6). All scores were significantly higher in patients with unfavorable outcomes than in those with favorable outcomes. Multivariable logistic regression analysis indicated that CHADS2 and the ATRIA score were positively correlated with unfavorable outcomes after adjusting for body mass index and variables with p < 0.1 in the univariable analysis (CHADS2 score: odds ratio [OR], 1.484; 95% confidence interval [CI], 1.290−1.950; p = 0.005, ATRIA score, OR, 1.128; 95% CI, 1.041−1.223; p = 0.004). Conclusions: The CHADS2 and ATRIA scores were positively correlated with unfavorable outcomes and could be used to predict unfavorable outcomes in patients who receive EVT.
