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

Georgios Tsivgoulis, Konstantinos Spengos, Panagiota Manta, Nikolaos Karandreas, Thomas Zambelis, Nikolaos Zakopoulos, Demetrios Vassilopoulos

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE - 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. METHODS - 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 [<60 years=0, ≥60 years=1]; blood pressure [systolic ≤140 mm Hg and diastolic ≤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 [<10 minutes=0, 10 to 59 minutes=1, ≥60 minutes=2]) was used to stratify the 30-day stroke risk. RESULTS - 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 <0.00001). After adjustment for stroke risk factors, history of previous TIA, medication use before the index TIA, and secondary prevention treatment strategies, an ABCD score of 5 to 6 was independently (P<0.001) associated with an 8-fold greater 30-day risk of stroke (hazard ratio, 8.01; 95% CI, 3.21 to 19.98). CONCLUSIONS - Our findings validate the predictive value of the ABCD score in identifying hospitalized TIA patients with a high risk of early stroke and provide further evidence for its potential applicability in clinical practice.

Original languageEnglish (US)
Pages (from-to)2892-2897
Number of pages6
JournalStroke
Volume37
Issue number12
DOIs
StatePublished - Dec 1 2006
Externally publishedYes

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Transient Ischemic Attack
Stroke
Hospital Records
Secondary Prevention
Hospital Emergency Service
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

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. / Tsivgoulis, Georgios; Spengos, Konstantinos; Manta, Panagiota; Karandreas, Nikolaos; Zambelis, Thomas; Zakopoulos, Nikolaos; Vassilopoulos, Demetrios.

In: Stroke, Vol. 37, No. 12, 01.12.2006, p. 2892-2897.

Research output: Contribution to journalArticle

Tsivgoulis, Georgios ; Spengos, Konstantinos ; Manta, Panagiota ; Karandreas, Nikolaos ; Zambelis, Thomas ; Zakopoulos, Nikolaos ; Vassilopoulos, Demetrios. / 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. In: Stroke. 2006 ; Vol. 37, No. 12. pp. 2892-2897.
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abstract = "BACKGROUND AND PURPOSE - 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. METHODS - 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 [<60 years=0, ≥60 years=1]; blood pressure [systolic ≤140 mm Hg and diastolic ≤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 [<10 minutes=0, 10 to 59 minutes=1, ≥60 minutes=2]) was used to stratify the 30-day stroke risk. RESULTS - 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 <0.00001). After adjustment for stroke risk factors, history of previous TIA, medication use before the index TIA, and secondary prevention treatment strategies, an ABCD score of 5 to 6 was independently (P<0.001) associated with an 8-fold greater 30-day risk of stroke (hazard ratio, 8.01; 95{\%} CI, 3.21 to 19.98). CONCLUSIONS - Our findings validate the predictive value of the ABCD score in identifying hospitalized TIA patients with a high risk of early stroke and provide further evidence for its potential applicability in clinical practice.",
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T2 - A hospital-based case series study

AU - Tsivgoulis, Georgios

AU - Spengos, Konstantinos

AU - Manta, Panagiota

AU - Karandreas, Nikolaos

AU - Zambelis, Thomas

AU - Zakopoulos, Nikolaos

AU - Vassilopoulos, Demetrios

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N2 - BACKGROUND AND PURPOSE - 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. METHODS - 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 [<60 years=0, ≥60 years=1]; blood pressure [systolic ≤140 mm Hg and diastolic ≤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 [<10 minutes=0, 10 to 59 minutes=1, ≥60 minutes=2]) was used to stratify the 30-day stroke risk. RESULTS - 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 <0.00001). After adjustment for stroke risk factors, history of previous TIA, medication use before the index TIA, and secondary prevention treatment strategies, an ABCD score of 5 to 6 was independently (P<0.001) associated with an 8-fold greater 30-day risk of stroke (hazard ratio, 8.01; 95% CI, 3.21 to 19.98). CONCLUSIONS - Our findings validate the predictive value of the ABCD score in identifying hospitalized TIA patients with a high risk of early stroke and provide further evidence for its potential applicability in clinical practice.

AB - BACKGROUND AND PURPOSE - 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. METHODS - 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 [<60 years=0, ≥60 years=1]; blood pressure [systolic ≤140 mm Hg and diastolic ≤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 [<10 minutes=0, 10 to 59 minutes=1, ≥60 minutes=2]) was used to stratify the 30-day stroke risk. RESULTS - 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 <0.00001). After adjustment for stroke risk factors, history of previous TIA, medication use before the index TIA, and secondary prevention treatment strategies, an ABCD score of 5 to 6 was independently (P<0.001) associated with an 8-fold greater 30-day risk of stroke (hazard ratio, 8.01; 95% CI, 3.21 to 19.98). CONCLUSIONS - Our findings validate the predictive value of the ABCD score in identifying hospitalized TIA patients with a high risk of early stroke and provide further evidence for its potential applicability in clinical practice.

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