New prognostic instrument improves prediction of stroke risk after TIA

January 25, 2007

The existing prognostic scores for early-risk stroke prediction after transient ischaemic attack (TIA)* have been validated and refined to develop a unified score that is more predictive than previous methods, according to an Article published in this week's issue of The Lancet.

About 240,000 TIAs are diagnosed every year in the USA, and about 70000 in the UK. Recent studies have shown that 4-20% of these patients will have a stroke within 90 days of a TIA, and half within the first two days. Identification of those at highest and lowest risk of stroke in the first days and weeks after a TIA would allow appropriate use of costly secondary prevention strategies, including hospital admission. However, it has not been possible to estimate individual risk with sufficient accuracy to guide clinical decisions. Two prognostic scores for estimating short-term risk of stroke after TIA have been proposed-- ABCD score and the California score--they estimate the risk for stroke within 7 days or 90 days, respectively, after presentation with TIA. However, the 2-day risk is often most relevant for decisions about necessity of urgent evaluation and observation.

Claiborne Johnston (Department of Neurology, University of California, San Francisco, USA) and colleagues validated the two existing prognostic scores in large independent groups from different populations, comparing predictions of stroke risk at 2, 7, and 90 days. Since both previous prognostic scores predicted stroke risk reliably across a wide range of populations and contained several similar components, the researchers generated a new unified score for optimum 2-day risk. The new score, ABCD² (ABCD squared)† was a more accurate predictor of risk of stroke than either of the two previous scores in the two derivation groups, and generally performed better in the four validation cohorts, thus creating a sole single standard for use in clinical care and public education.

Professor Johnston states: "We did the study because there continues to be a lot of confusion and inconsistency among physicians treating patients with TIA. Some admit nearly all such patients to the hospital while others monitor in the outpatient setting. This new score should be very useful in deciding who should come into the hospital right away." (Quote by email; does not appear in published paper)
-end-
See accompanying Comment

Dr S Claiborne Johnston, Department of Neurology, University of California, San Francisco, USA. T) +1 415 502 7487

Lancet

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.