Wang et al developed a score for predicting the risk of stroke or death within 5 years for a patient with new-onset atrial fibrillation. This can help identify those patients who may benefit from interventions. The authors are from the Framingham Heart Study and most are from Boston.
NOTES:
(1) The concurrent point score for predicting risk of stroke alone is in 17.10.14.
Parameters:
(1) age
(2) systolic blood pressure (based on the mean of 2 physician measurements)
(3) diabetes mellitus (fasting glucose >= 140 mg/dL; a random glucose >= 200 mg/dL; use of insulin or a hypoglycemic agent)
(4) cigarette smoker (smoked cigarettes within past year)
(5) prior history of myocardial infarct or congestive heart failure
(6) murmur
(7) left ventricular hypertrophy on ECG
|
Parameter |
Finding |
Points |
|---|---|---|
|
age in years |
55 years |
0 |
|
|
56 years |
1 |
|
|
57 years |
2 |
|
|
58 or 59 years |
3 |
|
|
60 years |
4 |
|
|
61 years |
5 |
|
|
62 years |
6 |
|
|
63 years |
7 |
|
|
64 or 65 years |
8 |
|
|
66 years |
9 |
|
|
67 years |
10 |
|
|
68 years |
11 |
|
|
69 years |
12 |
|
|
70 or 71 years |
13 |
|
|
72 years |
14 |
|
|
73 years |
15 |
|
|
74 years |
16 |
|
|
75 years |
17 |
|
|
76 or 77 years |
18 |
|
|
78 years |
19 |
|
|
79 years |
20 |
|
|
80 years |
21 |
|
|
81 years |
22 |
|
|
82 or 83 years |
23 |
|
|
84 years |
24 |
|
|
85 years |
25 |
|
|
86 years |
26 |
|
|
87 years |
27 |
|
|
88 years |
28 |
|
|
89 years |
29 |
|
|
90 or 91 years |
30 |
|
|
92 years |
31 |
|
|
93 years |
32 |
|
|
94 years |
33 |
|
systolic blood pressure |
< 120 mm Hg |
0 |
|
|
120 - 139 mm Hg |
1 |
|
|
140 - 159 mm Hg |
2 |
|
|
160 - 179 mm Hg |
3 |
|
|
>= 180 mm Hg |
5 |
|
diabetes mellitus |
no |
0 |
|
|
yes |
4 |
|
smoker |
no |
0 |
|
|
yes |
5 |
|
previous history of MI or CHF |
no |
0 |
|
|
yes |
6 |
|
murmur |
no |
0 |
|
|
yes |
4 |
|
LVH on ECG |
no |
0 |
|
|
yes |
2 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 59
• The higher the score the greater the risk of stroke or death within 5 years.
|
Total Score |
5 Year Risk of Stroke |
|---|---|
|
0 |
8% |
|
1 |
9% |
|
2 or 3 |
10% |
|
4 |
11% |
|
5 |
12% |
|
6 |
13% |
|
7 |
15% |
|
8 |
16% |
|
9 |
17% |
|
10 |
19% |
|
11 |
20% |
|
12 |
22% |
|
13 |
24% |
|
14 |
26% |
|
15 |
28% |
|
16 |
30% |
|
17 |
32% |
|
18 |
35% |
|
19 |
37% |
|
20 |
40% |
|
21 |
43% |
|
22 |
46% |
|
23 |
49% |
|
24 |
52% |
|
25 |
55% |
|
26 |
58% |
|
27 |
61% |
|
28 |
66% |
|
29 |
68% |
|
30 |
71% |
|
31 |
75% |
|
32 |
78% |
|
>= 33 |
> 80% |
If this data is entered into JMP, the following third order equation is derived:
risk of stroke or death in 5 years as a percent (from 0 to 100) =
= (-0.000539 * ((points)^3)) + (0.0761999 * ((points)^2)) + (0.272659 * (points)) + 8.7380027
Specialty: Neurology
ICD-10: ,
