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Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule.
Galvin, Rose; Atanassova, Penka A; Motterlini, Nicola; Fahey, Tom; Dimitrov, Borislav D
<p>The original article is available at <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p> <h4>Background</h4> <p>The ABCD<sup>2</sup> 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 ABCD<sup>2</sup> rule in a Bulgarian hospital up to three years after TIA.</p> <h4>Methods</h4> <p>All consecutive admissions to an emergency department with symptoms of a first TIA were included. Baseline data and clinical examinations including the ABCD<sup>2</sup> scores were documented by neurologists. Discrimination and calibration performance was examined using ABCD<sup>2</sup> 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 ABCD<sup>2</sup> score within the logistic regression analysis.</p> <h4>Results</h4> <p>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 (AUC<sub>ROC</sub> = 0 · 72, 95% CI 0 · 58-0 · 86), as well as a moderate calibration performance at three years.</p> <h4>Conclusion</h4> <p>This validation of the ABCD<sup>2</sup> rule in a Bulgarian hospital demonstrates that the rule has good predictive and discriminative performance at three years. The ABCD<sup>2</sup> is quick to administer and may serve as a useful tool to assist clinicians in the long-term management of individuals with TIA.</p>
Keyword(s): Stroke; Transient ischaemic attack; Risk prediction; ABCD2 rule; Bulgaria; Medicine and Health Sciences
Publication Date:
2014
Type: Journal article
Peer-Reviewed: Yes
Institution: Royal College of Surgeons in Ireland
Citation(s): 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.
Publisher(s): BioMed Central
File Format(s): application/pdf
Related Link(s): http://epubs.rcsi.ie/gpart/49
First Indexed: 2015-07-31 15:35:47 Last Updated: 2018-02-13 07:17:33