CHA2DS2-VASc Score
Stratifies stroke risk in non-valvular atrial fibrillation to guide anticoagulation decisions
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; surfaces a disagreement, never overwrites
- Care settings
- Emergency department, Inpatient, Outpatient
Calculate
Answer every item. The result uses the same scoring code Scribeable runs in notes. Nothing you enter leaves this page.
18 to 120 years.
Sex
Congestive heart failure or LV dysfunction
Hypertension
Prior stroke, TIA, or thromboembolism
Vascular disease (prior MI, peripheral artery disease, aortic plaque)
Diabetes mellitus
Enter the values above to see the result.
When it activates
Scribeable activates a calculator from the encounter. The CHA2DS2-VASc Score can activate when the transcript or pasted chart context documents any of these:
- New-onset atrial fibrillation
- Atrial flutter
- Anticoagulation decision needed
- Stroke/TIA in AFib patient
- AFib discovered incidentally
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: I48.
Note-type scope: it activates on notes whose subject resolves to cardiology, emergency medicine, critical care, hospital medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
7 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Patient age | age | years | Scored 1 if 65–74, 2 if ≥75. |
| Biological sex | history |
| Female sex scores +1. |
| History of CHF/LV dysfunction | history | Prior CHF / reduced ejection fraction / cardiomyopathy (CHA2DS2-VASc: 1 point). Asked as: “Does the patient have a history of congestive heart failure or LV dysfunction?” | |
| Hypertension history | history | Diagnosed hypertension, treated or untreated (CHA2DS2-VASc: 1 point). Asked as: “Does the patient have a history of hypertension?” | |
| Prior stroke/TIA/thromboembolism | history | PRIOR stroke / TIA / systemic thromboembolism — not an acute index event (CHA2DS2-VASc: 2 points). Asked as: “Does the patient have a history of prior stroke, TIA, or thromboembolism?” | |
| Vascular disease (MI, PAD, aortic plaque) | history | Prior MI, PAD, or aortic plaque (CHA2DS2-VASc: 1 point). Asked as: “Does the patient have vascular disease (prior MI, peripheral arterial disease, or aortic plaque)?” | |
| Diabetes mellitus | history | Type 1 or type 2 diabetes mellitus (CHA2DS2-VASc: 1 point). Asked as: “Does the patient have diabetes mellitus?” |
Scoring
CHF=1, HTN=1, Age 65-74=1, Age>=75=2, Diabetes=1, Stroke/TIA=2, Vascular disease=1, Female=1
CHF History of CHF/LV dysfunction + HTN Hypertension history + Age Patient age + DM Diabetes mellitus + Stroke/TIA Prior stroke/TIA/thromboembolism + Vascular Vascular disease (MI, PAD, aortic plaque) + Sex Biological sex
Interpretation
Score >=2 males or >=3 females: anticoagulation indicated (prefer DOACs). Score 1 male/2 female: consider anticoagulation. Score 0 male/1 female: no anticoagulation.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Lip GY et al. Refining clinical risk stratification for predicting stroke and thromboembolism in AFLip et al. (CHA2DS2-VASc) 2010 · 2010 · Level I · link last verified 2026-03-23
- ACC/AHA/ACCP/HRS Guideline for Diagnosis and Management of Atrial FibrillationACC/AHA AF 2023 · 2023 · ACC/AHA/ACCP/HRS · Class I, LOE A · link last verified 2026-03-23
How Scribeable handles it in the note
Scribeable never overwrites a CHA2DS2-VASc Score value that you or the draft state. The inputs are resolved from the transcript and chart and the score is re-computed in code, and when the computed value disagrees with the stated one, the disagreement is shown beside the draft for you to adjudicate.
A comorbidity the chart cannot establish is treated as unknown rather than absent: the computed value is then non-authoritative and you are asked the question instead of the score defaulting to zero.
Classified as a mandatory rule-out score: a missed result carries acute harm, so the activation filter never approves it on uncertainty.
See it activate on your own encounter
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