Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Functional Outcomes in Acute Ischemic Stroke Patients Who Received Endovascular Thrombectomy

Author:

Kim Hyung Jun1ORCID,Park Moo-Seok1,Yoo Joonsang2ORCID,Kim Young Dae3ORCID,Park Hyungjong4,Kim Byung Moon5,Bang Oh Young6,Kim Hyeon Chang7ORCID,Han Euna8ORCID,Kim Dong Joon5ORCID,Heo JoonNyung3ORCID,Choi Jin Kyo9ORCID,Lee Kyung-Yul10,Lee Hye Sun11ORCID,Shin Dong Hoon12ORCID,Choi Hye-Yeon13ORCID,Sohn Sung-Il4ORCID,Hong Jeong-Ho4ORCID,Lee Jong Yun14ORCID,Baek Jang-Hyun15ORCID,Kim Gyu Sik16,Seo Woo-Keun6ORCID,Chung Jong-Won6,Kim Seo Hyun17ORCID,Han Sang Won18,Park Joong Hyun18,Kim Jinkwon2ORCID,Jung Yo Han10ORCID,Cho Han-Jin19,Ahn Seong Hwan20ORCID,Lee Sung Ik21,Seo Kwon-Duk16ORCID,Chang Yoonkyung22ORCID,Nam Hyo Suk3ORCID,Song Tae-Jin1ORCID

Affiliation:

1. Department of Neurology, Seoul Hospital, College of Medicine, Ewha Woman’s University, Seoul 07804, Korea

2. Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea

3. Department of Neurology, Yonsei University College of Medicine, Seoul 03722, Korea

4. Department of Neurology, Keimyung University School of Medicine, Daegu 42601, Korea

5. Department of Radiology, Yonsei University College of Medicine, Seoul 03722, Korea

6. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea

7. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea

8. College of Pharmacy, Yonsei Institute for Pharmaceutical Research, Yonsei University, Incheon 21983, Korea

9. Department of Neurology, Seoul Medical Center, Seoul 02053, Korea

10. Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea

11. Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 03722, Korea

12. Department of Neurology, Gachon University Gil Medical Center, Incheon 21565, Korea

13. Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Korea

14. Department of Neurology, National Medical Center, Seoul 04564, Korea

15. Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea

16. Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea

17. Department of Neurology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea

18. Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Korea

19. Department of Neurology, Pusan National University School of Medicine, Busan 49241, Korea

20. Department of Neurology, Chosun University School of Medicine, Gwangju 61453, Korea

21. Department of Neurology, Sanbon Hospital, Wonkwang University School of Medicine, Gunpo 15865, Korea

22. Department of Neurology, Mokdong Hospital, College of Medicine, Ewha Woman’s University, Seoul 07985, Korea

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.

Funder

Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea

Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education

Publisher

MDPI AG

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