Can the ABCD Score be dichotomised to identify high-risk patients with transient ischaemic attack in the emergency department?
Key result
ABCD score ≥5 identifies 100% of 7-day post-TIA strokes in observational cohort.
- Sensitivity 100%
- 95% CI 40% to 100%
- n=98
Why the study?
Identification of patients with TIA at high short-term risk of stroke using the ABCD Score and its dichotomisation needed evaluation in emergency department settings.
Does dichotomising the ABCD Score identify high-risk patients for subsequent stroke at 7 and 90 days among those presenting with TIA to the emergency department?
Population
98 consecutive patients with probable or definite TIA presenting to a metropolitan hospital emergency department
Comparison
ABCD Score ≥ 5 (high risk) vs ABCD Score < 5 (low risk)
Design
Retrospective audit
Follow-up
90 days
Authors
Discussion
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Member takes
Implication
Supports dichotomized ABCD score for short-term stroke risk after TIA in ED; leaves open prospective validation before routine adoption.
Study Design
Type
Observational (n=98)
Multicenter
No
Structured PICO
Does dichotomising the ABCD Score identify high-risk patients for subsequent stroke at 7 and 90 days among those presenting with TIA to the emergency department?
P
Population
98 consecutive patients with probable or definite TIA presenting to an emergency department, evaluated for subsequent strokes within 90 days.
E
Exposure
Dichotomised ABCD Score (score ≥ 5 considered high risk for stroke)
C
Comparator
ABCD Score < 5 (low risk)
O
Outcome
Subsequent stroke at 7 and 90 dayshard clinical
Main Result
Effect estimate: Sensitivity 100% (95% CI 40% to 100%)
Dichotomising the ABCD Score at ≥ 5 provides a highly sensitive, though moderately specific, method to identify TIA patients at high short-term risk of stroke in the emergency department.
Limitations
- Retrospective analysis
- Overinclusive (high false-positive rate)
- retrospective analysis
- overinclusive (high false-positive rate)
Cite This Study
Bray et al. (2007) conducted an observational in Transient ischaemic attack (TIA) (n=98). ABCD Score ≥ 5 vs. ABCD Score < 5 was evaluated on Stroke within 7 days (Sensitivity 100%, 95% CI 40% to 100%). Dichotomising the ABCD Score to ≥5 in patients with TIA identified all strokes within 7 days (sensitivity 100%, 95% CI 40-100%) and 6 of 7 strokes within 90 days.