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Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule

Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule
Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule
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




1756-0500
281
Galvin, Rose
f401c5d2-6765-4c90-bc0b-5727f9824dbd
Atanassova, Penka A.
db224499-1eca-4548-8968-57f905c4582a
Motterlini, Nicola
c1ddd181-4c17-4635-9680-e12aabde6e69
Fahey, Tom
c0fd145a-af82-4c37-bce0-1c2e3e30c0f9
Dimitrov, Borislav D.
366d715f-ffd9-45a1-8415-65de5488472f
Galvin, Rose
f401c5d2-6765-4c90-bc0b-5727f9824dbd
Atanassova, Penka A.
db224499-1eca-4548-8968-57f905c4582a
Motterlini, Nicola
c1ddd181-4c17-4635-9680-e12aabde6e69
Fahey, Tom
c0fd145a-af82-4c37-bce0-1c2e3e30c0f9
Dimitrov, Borislav D.
366d715f-ffd9-45a1-8415-65de5488472f

Galvin, Rose, Atanassova, Penka A., Motterlini, Nicola, Fahey, Tom and Dimitrov, Borislav D. (2014) Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule. BMC Research Notes, 7 (1), 281. (doi:10.1186/1756-0500-7-281).

Record type: Article

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




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Published date: 4 May 2014
Organisations: Primary Care & Population Sciences

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Local EPrints ID: 365056
URI: https://eprints.soton.ac.uk/id/eprint/365056
ISSN: 1756-0500
PURE UUID: 4e49ea41-edba-438b-b2d7-16a48a66a75c

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Date deposited: 20 May 2014 08:30
Last modified: 19 Jul 2019 21:12

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