Michael Knoflach1, Wilfried Lang2, Leonhard Seyfang2, Elisabeth Fertl2, Stefan Oberndorfer2, Gerhard Daniel2, Thomas Seifert-Held2, Michael Brainin2, Stefan Krebs2, Benjamin Matosevic2, Thomas Töll2, Stefan Kiechl2, Johann Willeit2, Julia Ferrari2. 1. From the Department of Neurology (M.K., B.M., T.T., S. Kiechl, J.W.), Innsbruck Medical University; Department of Neurology (W.L., S. Krebs, J.F.), Hospital Barmherzige Brueder; Danube University Krems and Gesundheit Österreich GmbH/BIQG (L.S.); Department of Neurology (E.F.), Hospital Rudolfstiftung, Vienna; Department of Neurology (S.O.), University Clinic St Pölten; Department of Neurology (G.D.), Hospital Wilhelminenspital, Wien; Department of Neurology (T.S.-H.), Medical University of Graz; Department of Clinical Neurosciences and Preventive Medicine (M.B.), Danube University Krems; and Department of Neurology (M.B.), Karl Landsteiner University Hospital Tulln, Austria. Michael.Knoflach@i-med.ac.at. 2. From the Department of Neurology (M.K., B.M., T.T., S. Kiechl, J.W.), Innsbruck Medical University; Department of Neurology (W.L., S. Krebs, J.F.), Hospital Barmherzige Brueder; Danube University Krems and Gesundheit Österreich GmbH/BIQG (L.S.); Department of Neurology (E.F.), Hospital Rudolfstiftung, Vienna; Department of Neurology (S.O.), University Clinic St Pölten; Department of Neurology (G.D.), Hospital Wilhelminenspital, Wien; Department of Neurology (T.S.-H.), Medical University of Graz; Department of Clinical Neurosciences and Preventive Medicine (M.B.), Danube University Krems; and Department of Neurology (M.B.), Karl Landsteiner University Hospital Tulln, Austria.
Abstract
OBJECTIVE: It is not clear whether risk scores for early stroke recurrence after TIA that have been mainly established in outpatient and emergency department settings are valid on the background of highly specialized stroke unit care. METHODS: ABCD2 and ABCD3-I scores have been prospectively documented in a cohort of patients admitted to Austrian stroke units within 24 hours of symptom onset with TIA or minor stroke (NIH Stroke Scale score <4). RESULTS: A total of 5,237 TIA and minor stroke patients met inclusion criteria, with 3-month follow-up data available on 2,457. Early and 3-month stroke were observed in 2.4% and 4.2% of the study population. The probability of early stroke during the stroke unit stay (median 2 [interquartile range 1-3] days) steadily increased from 0% to 4.8% and 0% to 16.7% with increasing ABCD2 and ABCD3-I score points, respectively. On 3-month follow-up, stroke risk increased from 0% to 8.0% and 0% to 23.8% with increasing ABCD2 and ABCD3-I score points, respectively. Of the individual score components, age, blood pressure, and diabetes were not related to early or 3-month stroke, whereas clinical presentation (C), symptom duration (D), and cerebral as well as carotid imaging (I) were and accounted for the information provided by the full scores. CONCLUSIONS: Standard ABCD2 and ABCD3-I scores are useful instruments to estimate the probability of early and 3-month stroke in TIA and minor stroke patients treated at specialized stroke units, with C, D, and I being the most important score components in this setting.
OBJECTIVE: It is not clear whether risk scores for early stroke recurrence after TIA that have been mainly established in outpatient and emergency department settings are valid on the background of highly specialized stroke unit care. METHODS:ABCD2 and ABCD3-I scores have been prospectively documented in a cohort of patients admitted to Austrian stroke units within 24 hours of symptom onset with TIA or minor stroke (NIH Stroke Scale score <4). RESULTS: A total of 5,237 TIA and minor strokepatients met inclusion criteria, with 3-month follow-up data available on 2,457. Early and 3-month stroke were observed in 2.4% and 4.2% of the study population. The probability of early stroke during the stroke unit stay (median 2 [interquartile range 1-3] days) steadily increased from 0% to 4.8% and 0% to 16.7% with increasing ABCD2 and ABCD3-I score points, respectively. On 3-month follow-up, stroke risk increased from 0% to 8.0% and 0% to 23.8% with increasing ABCD2 and ABCD3-I score points, respectively. Of the individual score components, age, blood pressure, and diabetes were not related to early or 3-month stroke, whereas clinical presentation (C), symptom duration (D), and cerebral as well as carotid imaging (I) were and accounted for the information provided by the full scores. CONCLUSIONS: Standard ABCD2 and ABCD3-I scores are useful instruments to estimate the probability of early and 3-month stroke in TIA and minor strokepatients treated at specialized stroke units, with C, D, and I being the most important score components in this setting.
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