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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.
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.
Keyword(s): stroke; transient ischaemic attack; risk prediction; Bulgaria
Publication Date:
2014
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University of Limerick
Funder(s): Health Research Board
Citation(s): BMC Research Notes;7:281
HRC/2007/1
Publisher(s): BioMed Central
First Indexed: 2015-12-02 05:31:32 Last Updated: 2018-07-08 06:29:09