The ABCD score predicted 30-day stroke risk after TIA (OR 2.62 per point; P=0.0017), and adding CT scan findings further improved prediction (OR 2.89 per point; P=0.0003).
Cohort (n=274)
Yes
Does the ABCD score and the addition of CT findings (ABCDI score) predict short-term stroke risk in patients presenting to the ED within 24 hours of a TIA?
The ABCD score effectively predicts short-term stroke risk after TIA, and incorporating CT findings (ABCDI score) further improves this prognostic value.
Odds Ratio: 2.62
p-value: p=0.0017
BACKGROUND AND PURPOSE: A 6-point score, based on age, blood pressure, clinical features, and duration (ABCD), was shown to effectively stratify the short-term risk of stroke after a transient ischemic attack (TIA). Prospective validation in different populations of patients should precede its widespread use. Whether adding computed tomography (CT) scan findings to the score would improve its performance deserves exploring. We aimed to validate the ABCD score in a prospective cohort of patients accessing Emergency Departments within 24 hours of a TIA in an area of northern Italy and to acquire preliminary data on CT-based refinement. METHODS: During a 6-month period, all TIA patients accessing the Emergency Departments of 13 Piemonte and Valle d'Aosta hospitals were prospectively enrolled and stratified according to the 6-point ABCD score and to a 7-point score (ABCDI, where I=imaging) incorporating CT findings. RESULTS: Of 274 patients, stroke occurred in 10 (3.6%) within 7 days and in 15 (5.5%) within 30 days. The ABCD score was predictive of stroke risk at both 7 and 30 days (odds ratio for every point of the score=2.55 at 7 days and 2.62 at 30 days; P for linear trend across the ABCD score levels=0.018 at 7 days and 0.0017 at 30 days). CT scan findings further increased prediction (odds ratio for every point of the score=2.68 at 7 days and 2.89 at 30 days; P for linear trend across the ABCDI score levels=0.0043 at 7 days and 0.0003 at 30 days). CONCLUSIONS: The ABCD score confirmed its prognostic value in this prospective cohort. CT results could further improve prediction.
Sciolla et al. (Fri,) conducted a cohort in Transient ischemic attack (TIA) (n=274). ABCD and ABCDI scores was evaluated on Stroke within 30 days (OR 2.62, p=0.0017). The ABCD score predicted 30-day stroke risk after TIA (OR 2.62 per point; P=0.0017), and adding CT scan findings further improved prediction (OR 2.89 per point; P=0.0003).