SPARC
Stroke Prevention Atrial fibrillation Risk Calculator. Risk/Benefits of anticoagulation and anti-platelet therapies for CVA in AF. Based on CHADS-2 and new Active-A trial.
SPARC.html
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<title>SPARC</title>
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</head><body onload="passAge();">
<form method="post" action="" name="FormName">
<p class="title">
Stroke Prevention Atrial Fibrillation Risk Calculator
</p>
<div name="demographics">
<table width="50%">
<tbody><tr>
<td class="heading1" width="25%">Patient name</td>
<td class="formtext"><input class="formtext" name="PatientName" oscarDB=patient_name type="text">
</td></tr>
<tr>
<td class="heading1">Date:</td>
<td class="formtext"><input class="formtext" name="TodaysDate" oscarDB=Today type="text">
</td></tr>
<tr>
<td class="heading1">Patients age:</td>
<td class="formtext"><input class="formtext" name="Age" id="Age" oscardb=age type="text">
</td></tr>
</tbody></table>
</div>
<br>
<div name="Questionnaire">
<table width="50%">
<tbody><tr>
<td class="heading1" width="60%">Associated medical conditions:</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>
<td class="answer"><input name="Q1" value="0" checked="checked" type="radio"></td>
<td class="answer"><input name="Q1" value="1" type="radio"></td>
</tr><tr>
</tr><tr class="even">
<td class="question"><p class="normal">Any history of HBP whether on treatment or not</p></td>
<td class="answer"><input name="Q2" value="0" checked="checked" type="radio"></td>
<td class="answer"><input name="Q2" value="1" type="radio"></td>
</tr>
<tr class="even">
<td class="question"><p class="normal">Age >= 75yrs</p></td>
<td class="answer"><input name="Q3" value="0" checked="checked" type="radio"></td>
<td class="answer"><input name="Q3" id="75" value="1" type="radio"></td>
</tr>
<tr class="even">
<td class="question"><p class="normal">Diabetes </p></td>
<td class="answer"><input name="Q4" value="0" checked="checked" type="radio"></td>
<td class="answer"><input name="Q4" value="1" type="radio"></td>
</tr>
<tr class="even">
<td class="question"><p class="normal">Prior stroke or TIA</p></td>
<td class="answer"><input name="Q5" value="0" checked="checked" type="radio"></td>
<td class="answer"><input name="Q5" value="2" type="radio"></td>
</tr><tr>
</tr></tbody></table>
<br>
<table>
<tbody><tr>
<td><input onclick="totalScore()" value="Calculate CHADS Score" type="button"></td>
<td><input name="Score" size="10" value="" type="text"></td>
</tr>
</tbody></table>
</div>
<br>
<br>
<div name="Risk" class="DoNotPrint">
Yearly Risk of Ischemic Stroke/NNT
<table width="50%">
<tbody><tr>
<td class="heading1" width="10%">CHADS Score</td>
<td class="heading1" width="10%">Untreated</td>
<td class="heading1" width="10%">On Warfarin</td>
<td class="heading1" width="10%">On ASA + Clopidogrel</td>
<td class="heading1" width="10%">On ASA</td>
</tr>
<tr id="0">
<td class="answer">0</td>
<td class="answer">1.9%</td>
<td class="answer">0.6%/79</td>
<td class="answer">1.1%/120</td>
<td class="answer">1.5%/239</td>
</tr>
<tr id="1">
<td class="answer">1</td>
<td class="answer">2.8%</td>
<td class="answer">0.9%/53</td>
<td class="answer">1.6%/81</td>
<td class="answer">2.2%/162</td>
</tr>
<tr id="2">
<td class="answer">2</td>
<td class="answer">4.0%</td>
<td class="answer">1.3%/37</td>
<td class="answer">2.2%/57</td>
<td class="answer">3.1%/114</td>
</tr>
<tr id="3">
<td class="answer">3</td>
<td class="answer">5.9%</td>
<td class="answer">1.9%/25</td>
<td class="answer">3.3%/39</td>
<td class="answer">4.6%/77</td>
</tr>
<tr id="4">
<td class="answer">4</td>
<td class="answer">8.5%</td>
<td class="answer">2.8%/18</td>
<td class="answer">4.8%/27</td>
<td class="answer">6.6%/53</td>
</tr>
<tr id="5">
<td class="answer">5</td>
<td class="answer">12.5%</td>
<td class="answer">4.1%/12</td>
<td class="answer">7.0%/18</td>
<td class="answer">9.8%/36</td>
</tr>
<tr id="6">
<td class="answer">6</td>
<td class="answer">18.2%</td>
<td class="answer">6.0%/8</td>
<td class="answer">10.2%/12</td>
<td class="answer">14.2%/25</td>
</tr>
</tbody></table>
<br>
Yearly Risk of Major Bleed/NNT-H
<table width="50%">
<tbody><tr>
<td class="heading1" width="10%">CHADS Score</td>
<td class="heading1" width="10%">Untreated</td>
<td class="heading1" width="10%">On Warfarin</td>
<td class="heading1" width="10%">On ASA + Clopidogrel</td>
<td class="heading1" width="10%">On ASA</td>
</tr>
<tr><td class="answer">0-6</td>
<td class="answer">0.6%</td>
<td class="answer">2.4-2.8%/56</td>
<td class="answer">2.0-2.2%/56</td>
<td class="answer">1.1%/222</td>
</tr>
</tbody></table>
<br>
<table width="50%">
<tbody><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>
</tr>
</tbody></table>
<br>
<br>
<div name="Application" class="DoNotPrint">
<table width="60%">
<tbody><tr>
<td class="heading1" colspan="2">Recommendations</td>
</tr>
<tr id="verylow">
<td>0</td>
<td>Very low risk of stroke (<2%), "lone AF": No treatment if <60yrs; ASA if 60-75 yrs.</td>
</tr>
<tr id="lowrisk">
<td>1</td>
<td>Low Risk of stroke (2-4%): Treat with ASA, ASA + Clopidrogel**, or Warfarin.</td>
</tr>
<tr id="intermediate">
<td>2-4</td>
<td>Intermediate Risk of stroke (6-8.5%): Recommend Warfarin (or ASA + Clopidogrel**).</td>
</tr>
<tr id="highrisk">
<td>5-6</td>
<td>High Risk of stroke (12.5-18%): Recommend Warfarin (or ASA + Clopidogrel**). Discuss risks and benefits.</td>
</tr>
</tbody></table>
<br>
<br>
<div name="Application" class="DoNotPrint">
<table width="60%">
<tbody><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 ~66%; treatment with aspirin + Clopidogrel
reduces risk by ~44%; treatment with ASA alone reduces risk by ~22%.</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>
<tr>
<td>6.** Numbers Needed to Treat for Harm on ASA +
Clopidogrel** is SAME as Warfarin. Choose this combination if there is
a non-bleeding contraindication to using Warfarin.</td>
</tr>
</tbody></table>
</div>
<br>
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