Validation of the ABCD score in identifying individuals at high early risk of Stroke after a transient ischemic attack: A hospital-based case series study

• Published in: Stroke (1970) 2006-12, Vol.37 (12), p.2892-2897
• Main Authors: TSIVGOULIS, Georgios, SPENGOS, Konstantinos, MANTA, Panagiota, KARANDREAS, Nikolaos, ZAMBELIS, Thomas, ZAKOPOULOS, Nikolaos, VASSILOPOULOS, Demetrios
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Cohort Studies; Female; Follow-Up Studies; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Hospitalization; Humans; Ischemic Attack, Transient - complications; Ischemic Attack, Transient - diagnosis; Ischemic Attack, Transient - epidemiology; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Pharmacology. Drug treatments; Research Design - standards; Retrospective Studies; Risk Factors; Severity of Illness Index; Stroke - diagnosis; Stroke - epidemiology; Stroke - etiology; Time Factors; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.0000249007.12256.4a

A simple score derived in the Oxfordshire Community Stroke Project (ABCD score) was able to identify individuals at high early risk of stroke after a transient ischemic attack (TIA) both in a population-based and a hospital-referred clinic cohort. We aimed to further validate the former score in a cohort of hospitalized TIA patients. We retrospectively reviewed the emergency room and hospital records of consecutive patients hospitalized in our neurological department with a definite TIA according to the World Health Organization (WHO) criteria during a 5-year period. The 6-point ABCD score (age [ or =60 years=1]; blood pressure [systolic < or =140 mm Hg and diastolic < or =90 mm Hg=0, systolic >140 mm Hg and/or diastolic >90 mm Hg=1]; clinical features [unilateral weakness=2, speech disturbance without weakness=1, other symptom=0]; duration of symptoms [ or =60 minutes=2]) was used to stratify the 30-day stroke risk. The 30-day risk of stroke in the present case series (n=226) was 9.7% (95% CI, 5.8% to 13.6%). The ABCD score was highly predictive of 30-day risk of stroke (ABCD=0 to 2: 0%, ABCD=3: 3.5% [95% CI, 0% to 8.2%], ABCD=4: 7.6% [95% CI, 1.2% to 14.0%], ABCD=5: 21.3% [95% CI, 10.4% to 33.0%], ABCD=6: 31.3% [95% CI, 8.6% to 54.0%]; log-rank test=23.09; df=6; P=0.0008; P for linear trend across the ABCD score levels