ABCD 2 , ABCD 2 -I, and OTTAWA scores for stroke risk assessment: a direct retrospective comparison.

Autor: Spampinato MD; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; School of Emergency Medicine, University of Ferrara, Ferrara, Italy., Covino M; Emergency Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy., Passaro A; Department of Translational Medicine, University of Ferrara, Ferrara, Italy., Guarino M; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; School of Emergency Medicine, University of Ferrara, Ferrara, Italy., Marziani B; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; School of Emergency Medicine, University of Ferrara, Ferrara, Italy., Ghirardi C; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; School of Emergency Medicine, University of Ferrara, Ferrara, Italy., Ricciardelli A; Emergency Medicine, Azienda Unità Sanitaria Locale, Ferrara, Italy., Fabbri IS; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; School of Emergency Medicine, University of Ferrara, Ferrara, Italy., Strada A; Emergency Medicine, St. Anna Hospital, Ferrara, Italy., Gasbarrini A; Internal Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy., Franceschi F; Emergency Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy. francesco.franceschi@unicatt.it., De Giorgio R; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; School of Emergency Medicine, University of Ferrara, Ferrara, Italy.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2022 Nov; Vol. 17 (8), pp. 2391-2401. Date of Electronic Publication: 2022 Aug 20.
DOI: 10.1007/s11739-022-03074-x
Abstrakt: 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 ABCD 2 , ABCD 2 -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. ABCD 2 , ABCD 2 -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 ABCD 2  > 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.
(© 2022. The Author(s).)
Databáze: MEDLINE
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