TY - JOUR
T1 - Long-term risk of stroke after transient ischaemic attack
T2 - A hospital-based validation of the ABCD2 rule
AU - Galvin, Rose
AU - Atanassova, Penka A.
AU - Motterlini, Nicola
AU - Fahey, Tom
AU - Dimitrov, Borislav D.
PY - 2014/5/4
Y1 - 2014/5/4
N2 - 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.
AB - 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.
KW - Bulgaria
KW - Risk prediction
KW - Stroke
KW - Transient ischaemic attack
UR - http://www.scopus.com/inward/record.url?scp=84900512619&partnerID=8YFLogxK
U2 - 10.1186/1756-0500-7-281
DO - 10.1186/1756-0500-7-281
M3 - Article
C2 - 24886654
AN - SCOPUS:84900512619
SN - 1756-0500
VL - 7
SP - 281-
JO - BMC Research Notes
JF - BMC Research Notes
IS - 1
M1 - 281
ER -