CHADS Score

So. What is the CHADS score? Well, it is a quick useful tool when making decisions about anti-coagulation in the setting of AF. It is based on a study published in JAMA 2001.

Patients are scored according to the following:

C - Congestive Heart Failure [1]
H - Hypertension [1]
A - Age > 75 [1]
D - Diabetes [1]
S - prior Stroke or TIA [2]

Patients are categorised according to risk, and treated accordingly
0 - low risk - aspirin
1 - mod risk - aspirin or warfarin
2 - mod->high risk - warfarin

Patients with a score of 0 have a 1.9% annual risk of stroke, and patients with a score of 6 have a risk of 18.2%. In the normal population with no AF the risk of stroke is 1%.

Aspirin reduces the risk by 25% and warfarin by 66%.
The risk of a major bleed is 1-2% per year.

Downfalls of the CHADS score is that patients with prior stroke and no other RFs, are mod to high, when in fact the risk is quite high. Secondly the model is based on age 65-95, and thus may not be as accurate in the younger age group.