esus_criteria: Embolic Stroke of Undetermined Source (ESUS) Criteria

In cliot: Clinical Indices and Outcomes Tools

Embolic Stroke of Undetermined Source (ESUS) Criteria

Description

Evaluates whether a patient meets the criteria for Embolic Stroke of Undetermined Source (ESUS). This classification requires the visualization of a non-lacunar ischemic stroke and the exclusion of other specific causes such as atherosclerosis, cardioembolism, and other uncommon etiologies.

Usage

esus_criteria(ischemic_stroke_ct_mri, extracranial_stenosis_lt_50,
              afib_flutter_absent, cardiac_embolism_source_absent,
              other_causes_absent)

Arguments

ischemic_stroke_ct_mri	Numeric (0 or 1). Ischemic stroke visualized on CT or MRI that is not lacunar? (1 = Yes).
extracranial_stenosis_lt_50	Numeric (0 or 1). Absence of extracranial or intracranial atherosclerosis causing >= 50% luminal stenosis in arteries supplying the ischemic area? (1 = Yes/Absent).
afib_flutter_absent	Numeric (0 or 1). No major-risk cardioembolic source of embolism? (Specifically AFib/Flutter). Requires >= 24 hours of cardiac monitoring. (1 = Yes/Absent).
cardiac_embolism_source_absent	Numeric (0 or 1). No other major-risk cardioembolic source? (e.g., intracardiac thrombus, prosthetic valve, atrial myxoma, recent MI <4 weeks, LVEF <30%, etc.). (1 = Yes/Absent).
other_causes_absent	Numeric (0 or 1). No other specific cause of stroke identified (e.g., arteritis, dissection, migraine, drug misuse)? (1 = Yes/Absent).

Value

A list containing:

Diagnosis	"Criteria Met" or "Criteria Not Met".
Missing_Criteria	List of exclusion criteria that failed, if any.

References

Hart RG, Diener HC, Coutts SB, et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13(4):429-438. doi:10.1016/S1474-4422(13)70310-7

Examples

# Example 1: Diagnosis Confirmed
# Non-lacunar stroke, no stenosis, no AFib, no cardiac source, no other cause
esus_criteria(1, 1, 1, 1, 1)

# Example 2: Diagnosis Not Met (AFib present)
# Non-lacunar stroke, no stenosis, but AFib detected (input 0 for 'absent')
esus_criteria(1, 1, 0, 1, 1)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.