Long-term risk of stroke after transient ischaemic attack: a hosp.pdf (348.12 kB)

Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule.

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posted on 22.11.2019, 16:02 by Rose Galvin, Penka A. Atanassova, Nicola Motterlini, Tom Fahey, Borislav D. Dimitrov

Background

The ABCD2 clinical prediction rule is a seven point summation of clinical factors independently predictive of stroke risk. The purpose of this cohort study is to validate the ABCD2 rule in a Bulgarian hospital up to three years after TIA.

Methods

All consecutive admissions to an emergency department with symptoms of a first TIA were included. Baseline data and clinical examinations including the ABCD2 scores were documented by neurologists. Discrimination and calibration performance was examined using ABCD2 cut-off scores of ≥3, ≥4 and ≥5 points, consistent with the international guidelines. The Hosmer-Lemeshow test was used to examine calibration between the observed and expected outcomes as predicted by ABCD2 score within the logistic regression analysis.

Results

Eighty-nine patients were enrolled to the study with a mean age of 63 years (+/- 12 years). Fifty-nine percent (n = 53) of the study population was male. Seven strokes (7 · 8%) occurred within the first year and six further strokes within the three-year follow-up period. There was no incident of stroke within the first 90 days after TIA. The rule demonstrated good predictive (OR = 1 · 58, 95% CI 1 · 09-2 · 29) and discriminative performance (AUCROC = 0 · 72, 95% CI 0 · 58-0 · 86), as well as a moderate calibration performance at three years.

Conclusion

This validation of the ABCD2 rule in a Bulgarian hospital demonstrates that the rule has good predictive and discriminative performance at three years. The ABCD2 is quick to administer and may serve as a useful tool to assist clinicians in the long-term management of individuals with TIA.

Funding

Noel Hickey Research Bursary. Health Research Board.

History

Comments

The original article is available at www.biomedcentral.com

Published Citation

Galvin R, Atanassova PA, Motterlini N, Fahey T, Dimitrov BD. Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule. BMC Research Notes 2014, 7:281.

Publication Date

04/05/2014

Publisher

BioMed Central

PubMed ID

24886654

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