Rapid diagnosis and treatment of TIA results in low rates of stroke, myocardial infarction and vascular death

Cocho, Dolores; Monell, Joan; Planells, G.; Ricciardi, Ana Clara; Pons, Jordi; Boltes, Anuncia; Espinosa, J.; Ayats, M.; Garcia, Nelda; Otermín, Pilar

doi:10.1016/j.nrleng.2014.05.002

Cited by 1 publication

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“…Also, Perry et al [ 23 ] reported that the median sensitivity of clinical scores for TIA expected by physicians was higher than that reached by any existing scores, thus limiting their value in daily practice. An early diagnosis of TIA and a correct evaluation of several cardiovascular risk factors may aid adequate patient management leading to reduced rates of stroke, myocardial infarction, and vascular death as well as improved quality of life [ 24 , 25 ]. According to our results, ABCD 2 , ABCD 2 -I, and OTTAWA risk scores have moderate diagnostic accuracy, with an AUROC < 0.75 in predicting the occurrence of stroke within 7 and 90 days, and at 1 year.…”

Section: Discussionmentioning

confidence: 99%

ABCD2, ABCD2-I, and OTTAWA scores for stroke risk assessment: a direct retrospective comparison

et al. 2022

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Transient ischemic attack (TIA) is a neurologic emergency characterized by cerebral ischemia eliciting a temporary focal neurological deficit. Many clinical prediction scores have been proposed to assess the risk of stroke after TIA; however, studies on their clinical validity and comparisons among them are scarce. The objective is to compare the accuracy of ABCD2, ABCD2-I, and OTTAWA scores in the prediction of a stroke at 7, 90 days, and 1 year in patients presenting with TIA. Single-centre, retrospective study including patients with TIA admitted to the Emergency Department of our third-level, University Hospital, between 2018 and 2019. Five hundred three patients were included. Thirty-nine (7.7%) had a stroke within 1 year from the TIA: 9 (1.7%) and 24 (4.7%) within 7 and 90 days, respectively. ABCD2, ABCD2-I, and OTTAWA scores were significantly higher in patients who developed a stroke. AUROCs ranged from 0.66 to 0.75, without statistically significant differences at each time-point. Considering the best cut-off of each score, only ABCD2 > 3 showed a sensitivity of 100% only in the prediction of stroke within 7 days. Among clinical items of each score, duration of symptoms, previous TIA, hemiparesis, speech disturbance, gait disturbance, previous cerebral ischemic lesions, and known carotid artery disease were independent predictors of stroke. Clinical scores have moderate prognostic accuracy for stroke after TIA. Considering the independent predictors for stroke, our study indicates the need to continue research and prompts the development of new tools on predictive scores for TIA.

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Section: Discussionmentioning

confidence: 99%