Correlation Study Between CHADS₂ Score And CHA₂DS₂-VAS_c Score In The Prognosis Of Cerebral Infarction Patients With Atrial Fibrillation

Objective: Cerebral infarction with atrial fibrillation?AF?is a common type of cerebral infarction,and its mortality and disability rate are high.If the prognosis of cerebral infarction with AF can be predicted before the onset of stroke,it will be helpful to make a more reasonable medical decision.But,there is no accurate and effective prediction tool at present.The CHADS₂ score and the CHA₂DS₂-VAS_c score are stroke risk stratification systems for patients with AF.There has' t sufficient theoretical foundation of both score in predicting outcome in cerebral infarction with AF.The relationship between the pre-admission score and stroke outcome was examined in cerebral infarction's patients with AF.The aim of the study was to provide a theoretical basis for the selection of prognostic scale and medical decision making.Methods: 1.In the study,we selected consecutive cases of cerebral infarction patients with AF from 2014 October to 2015 November,and collected clinical data.All the consecutive cerebral infarction's patients with non-valvular atrial fibrillation?NVAF?were classified into subgroups according to prestroke CHADS₂ and CHA₂DS₂-VASc scores and followed up for 3 months.The end points were death and stroke recurrence.2.The three subgroups of CHADS₂ score or CHA₂DS₂-VASc scores were compared each other in baseline data,outcome of 30 days after stroke / discharge,and prognosis of 3 months after stroke.The study evaluated the sensitivity and specificity of the two scores in predicting the short-term prognosis of cerebral infarction's patients with AF.3.Multivariate Cox proportional hazards models showed that whether CHADS₂ and CHA₂DS₂-VAS_c score subgroups had an impact on stroke recurrence.The cumulative probability of survival period of each subgroup of two scores was analyzed,and the Kaplan-Meier survival curves of each group were drawn.Results: 1.In this study,112 cerebral infarction's patients with NVAF were enrolled?female 58 cases,male 54 cases?.At discharge or stroke 30 days,72 cases of patients have good prognosis,40 cases are bad.37 cases have good 3-month outcome,75 cases are poor.There are 17 cases of stroke recurrence,36 cases of death within three months.2.To predict merger AF patients with cerebral infarction stroke prognosis of 3months: The 0-1 group was significantly better than 2-6 group in the CHADS₂ score two component method?P < 0.01?,sensitivity was 70.67% and specificity was 64.86%.The0-2 group was significantly better than 3-9 group in the CHA₂DS₂-VAS_c score two component method?P < 0.01?,sensitivity was 86.67% and specificity was 43.24%.3.To predict the severity of stroke in patients with NVAF: CHADS₂ score three groups are statistical differences?P <0.05?,when comparing two no statistical difference?P >0.05?,there was no statistical difference in the scores of CHA₂DS₂-VAS_c scores?P > 0.05?.4.To predict merge AF early neural function in cerebral infarction's patients?discharge/30 days after stroke?recovery degree: There was no significant difference in both CHADS₂ score and CHA₂DS₂-VAS_c score among subgroups?P > 0.05?.5.To predict merger AF patients with cerebral infarction mortality 3 months: There was no statistical difference in CHA₂DS₂-VAS_c score?P >0.05?.There was a significant difference in each subgroup of CHADS₂ score?P < 0.05?.Conclusion: 1.This study suggests that CHADS₂ score,CHA₂DS₂-VAS_c score two components method to predict the 3 months the prognosis of cerebral infarction patients with AF is effective.CHADS₂ score more advantage,recommended use.2.CHADS₂ score predicts a limited role for mortality in 3 months after stroke in patients with atrial fibrillation.3.CHA₂DS₂-VAS_c score predicts recurrence of stroke in patients with atrial fibrillation 3 months after stroke is limited.4.There is no significant effect for two score to predicting the severity and the degree of recovery of early neurological function of stroke in patients with atrial fibrillation.