Title | Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule |
Publication Type | Published Journal Article |
2014 | |
Authors | Galvin R, Atanassova P, Motterlini N, Fahey T, Dimitrov BB |
Journal | BMC Research Notes |
Volume | 7 |
Date Published | 05/2014 |
Type of Article | Published Journal Article |
Keywords | Stroke; Transient ischaemic attack; Risk prediction; ABCD2 rule; Bulgaria |
Abstract | Abstract 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. |
URL | http://www.biomedcentral.com/1756-0500/7/281 |
DOI | 10.1186/1756-0500-7-281 |