CHADS 2 Score
Contributed by Dr. David Page. Calculates the CHADS2 Score, used to calculate the risk/benefits of using anti-coagulation in preventing a stroke.
CHADS2.html
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<title>CHADS 2</title>
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<form method="post" action="" name="FormName">
<p class="title">
CHADS2: Stroke risk assessment in Atrial Fibrillation in Non Valvular Heart disease
</p>
<div name="demographics">
<table width="70%">
<tr>
<td class="heading1" width=25%>Patient name</td>
<td class="formtext"><input class="formtext" name="PatientName" type="text" oscarDB=patient_name>
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<tr>
<td class="heading1">Date:</td>
<td class="formtext"><input class="formtext" name="TodaysDate" type="text" oscarDB=today>
</tr>
<tr>
<td class="heading1">Patients age:</td>
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</tr>
</table>
</div>
<br>
<div name="Questionnaire">
<table width="50%">
<tr>
<td class="heading1" width=60%>Associated medical conditions</u>:</td>
<td class="heading1" width=20%>Absent</td>
<td class="heading1" width=20%>Present</td>
</tr>
<tr class="even">
<td class="question"><p class="normal">Congestive heart failure within 90 days </p></td>
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<td class="answer"><input type="radio" name="Q1" value="1"></td>
<tr>
<tr class="even">
<td class="question"><p class="normal">Any history of HBP whether on treatment or not</p></td>
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<td class="answer"><input type="radio" name="Q2" value="1"></td>
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<td class="question"><p class="normal">Age >= 75yrs</p></td>
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<td class="question"><p class="normal">Diabetes </p></td>
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<td class="answer"><input type="radio" name="Q4" value="1"></td>
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<tr class="even">
<td class="question"><p class="normal">Prior stroke or TIA</p></td>
<td class="answer"><input type="radio" name="Q5" value="0"checked></td>
<td class="answer"><input type="radio" name="Q5" value="2"></td>
<tr>
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<br>
<table>
<tr>
<td><input type="button" onclick="totalScore()" value="Calculate CHADS Score"></td>
<td><input type="text" name="Score" size="10" value=""></td>
</tr>
</table>
</div>
<br>
<br>
<div name="Risk" class="DoNotPrint">
<table width=50%>
<tr>
<td class="heading1" width=10%>CHADS Score</td>
<td class="heading1" width=10%>Yearly Risk of Stroke</td>
<td class="heading1" width=10%>Event rate off warfarin (% per year)</td>
<td class="heading1" width=10%>Event rate on warfarin (% per year)</td>
<td class="heading1" width=10%>NNT</td>
</tr>
<tr id="0" >
<td class = "answer">0</td>
<td class = "answer">1.9% (1.2-3.0)</td>
<td class = "answer">0.49</td>
<td class = "answer">0.25</td>
<td class = "answer">417</td>
</tr>
<tr id="1">
<td class = "answer">1</td>
<td class = "answer">2.8% (2.0-3.8)</td>
<td class = "answer">1.52</td>
<td class = "answer">0.72</td>
<td class = "answer">125</td>
</tr>
<tr id="2">
<td class = "answer">2</td>
<td class = "answer">4.0% (3.1-5.1)</td>
<td class = "answer">2.50</td>
<td class = "answer">1.27</td>
<td class = "answer">81</td>
</tr>
<tr id="3">
<td class = "answer">3</td>
<td class = "answer">5.9% (4.6-7.3)</td>
<td class = "answer">5.27</td>
<td class = "answer">2.20</td>
<td class = "answer">33</td>
</tr>
<tr id="4">
<td class = "answer">4</td>
<td class = "answer">8.5% (6.3-11.1)</td>
<td class = "answer">6.02</td>
<td class = "answer">2.35</td>
<td class = "answer">27</td>
</tr>
<tr id="5">
<td class = "answer">5</td>
<td class = "answer">12.5% (8.2-17.5)</td>
<td class = "answer">6.88</td>
<td class = "answer">4.60</td>
<td class = "answer">44</td>
</tr>
<tr id="6">
<td class = "answer">6</td>
<td class = "answer">18.2% (10.5-27.4)</td>
<td class = "answer">-</td>
<td class = "answer">-</td>
<td class = "answer">-</td>
</tr>
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<br>
<table width = 70%>
<tr>
<td class="heading1" width=10%>Risk of major bleed</td>
<td class="heading1" width=10%>Less significant but worrisome bleed</td>
</tr>
<tr id= "low">
<td class = "answer">Age < 80yrs:Risk of major bleed 1% per year.</td>
<td class = "answer">Age >50yrs:Risk of minor bleed 5% per year.</td>
</tr>
<tr id="high">
<td class = "answer">Age > 80 yrs:Risk of major bleed 3.4% per year</td>
<td class = "answer"></td>
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<br>
<br>
<div name="Application" class="DoNotPrint">
<table width=80%>
<tr>
<td class="heading1" colspan="2">Recommendations</td>
</tr>
<tr id="severe">
<td>0-2</td>
<td>Low Risk of stroke (2-4%): Treat with ASA 325mg od. Could consider Warfarin for CHADS score 1 or 2.</td>
</tr>
<tr id="moderate">
<td>3-4</td>
<td>Intermediate Risk of stroke (6-8.5%): Discuss risk and benefits of Warfarin vs ASA.</td>
</tr>
<tr id="mild">
<td>5-6</td>
<td>High Risk of stroke (12.5-18%): Recommend Warfarin. Discuss risks and benefits.</td>
</tr>
</table>
<br>
<br>
<div name="Application" class="DoNotPrint">
<table width=80%>
<tr>
<td class="heading1" colspan="2">Notes:</td>
</tr>
<tr>
<td>1. Check TSH: hyperthyroidism is a major cause of atrial fibrillation.</td>
</tr>
<tr >
<td>2. Echocardiogram is not essential as the size of the atrium does not correlate with the rhythm or outcome.</td>
</tr>
<tr>
<td>3. Establish rate control with either B-blocker or a calcium channel blocker.</td>
</tr>
<tr>
<td>4. Treatment with warfarin reduces the risk of stroke in atrial fibrillation by about 66% and treatment with aspirin reduces risk by about 25%.</td>
</tr>
<tr>
<td>5. The risk of major bleeding on warfarin varies with the patients medical problems but is generally less than 2%.</td>
</tr>
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