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ABCD2 score

Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
Peter Appelros, Maria Háls Berglund, Jakob O Ström
BACKGROUND: In the absence of active management, the stroke risk after a transient ischemic attack (TIA) may be high. Almost 10 years ago, the results of the EXPRESS and SOS-TIA studies called for a more rapid management of TIA patients. The purpose of this study was to investigate the other stroke risks in the longer term, after the implementation of a more active approach to TIA. We also wanted to assess the predictive value of the ABCD2 score in this context. METHODS: Riksstroke is the national stroke registry in Sweden...
October 18, 2016: Cerebrovascular Diseases
Shawna Cutting, Elizabeth Regan, Vivien H Lee, Shyam Prabhakaran
BACKGROUND AND PURPOSE: Following transient ischemic attack (TIA), there is increased risk for ischemic stroke. The American Heart Association recommends admission of patients with ABCD2 scores ≥3 for observation, rapid performance of diagnostic tests, and potential acute intervention. We aimed to determine if there is a relationship between ABCD2 scores, in-hospital ischemic events, and in-hospital treatments after TIA admission. METHODS: We reviewed consecutive patients admitted between 2006 and 2011 following a TIA, defined as transient focal neurological symptoms attributed to a specific vascular distribution and lasting <24 h...
October 8, 2016: Cerebrovascular Diseases Extra
Salim Elyas, Angela C Shore, Hayley Kingwell, Samantha Keenan, Leigh Boxall, Jane Stewart, Martin A James, William David Strain
OBJECTIVE: Transient ischemic attacks (TIA) and minor strokes are important risk factors for recurrent strokes. Current stroke risk prediction scores such as ABCD2, although widely used, lack optimal sensitivity and specificity. Elevated urinary albumin excretion predicts cardiovascular disease, stroke, and mortality. We explored the role of microalbuminuria (using albumin creatinine ratio (ACR)) in predicting recurrence risk in patients with TIA and minor stroke. METHODS: Urinary ACR was measured on a spot sample in 150 patients attending a daily stroke clinic with TIA or minor stroke...
September 2016: Annals of Clinical and Translational Neurology
Mostafa Almasi, Nader Hodjati Firoozabadi, Faeze Ghasemi, Mojtaba Chardoli
Background. The ABCD2 score is now identified as a useful clinical prediction rule to determine the risk for stroke in the days following brain ischemic attacks. Aim. The present study aimed to introduce a new scoring system named "ABCD2F" and compare its value with the previous ABCD2 system to predict recurrent ischemic stroke within 90 days of the initial cerebrovascular accident (CVA). Methods. 138 consecutive patients with the final diagnosis of ischemic CVA or TIAs who referred to emergency ward of Rasoul-e-Akram general hospital in Tehran from September 2012 to December 2013 were eligible...
2016: Neurology Research International
Scott Munro, Sally Rodbard, Khalid Ali, Claire Horsfield, Wendy Knibb, Janet Holah, Ottilia Speirs, Tom Quinn
BACKGROUND: Suspected transient ischaemic attack (TIA) is a common presentation to emergency medical services (EMS) in the United Kingdom (UK). Several EMS systems have adopted the ABCD2 score to aid pre-hospital risk stratification and decision-making on patient disposition, such as direct referral to an Emergency Department or specialist TIA clinic. However, the ABCD2 score, developed for hospital use, has not been validated for use in the pre-hospital context of EMS care. METHODS: We conducted a pilot study to assess eligibility criteria, recruitment rates, protocol compliance, consent and follow-up procedures to inform the development of a definitive study to validate the ABCD2 tool in pre-hospital evaluation of patients with suspected TIA...
2016: Experimental & Translational Stroke Medicine
Graeme J Hankey
No abstract text is available yet for this article.
August 16, 2016: Annals of Internal Medicine
Michael Knoflach, Wilfried Lang, Leonhard Seyfang, Elisabeth Fertl, Stefan Oberndorfer, Gerhard Daniel, Thomas Seifert-Held, Michael Brainin, Stefan Krebs, Benjamin Matosevic, Thomas Töll, Stefan Kiechl, Johann Willeit, Julia Ferrari
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...
August 30, 2016: Neurology
Mojtaba Chardoli, Nader H Firoozabadi, Mohsen Nouri, Vafa Rahimi-Movaghar
Cerebrovascular attack (CVA) and transient ischemic attack (TIA) are major causes of emergency department visits around the globe. A significant number of these patients may experience repeat attacks if left untreated. Several risk stratifying scoring systems have been developed in recent years to point out the high risk patients. ABCD2 is based on age, blood pressure, clinical status, diabetes mellitus, and duration of symptoms and is used commonly for this purpose. In this study, we were to enhance its sensitivity and specificity with the addition of another criterion namely atrial fibrillation and making ABCD2-F...
June 2016: Acta Medica Iranica
Raymond W Grams, Chelsea S Kidwell, Amish H Doshi, Kendra Drake, Jennifer Becker, Bruce M Coull, Kambiz Nael
OBJECTIVE: Approximately 60% of patients with a clinical transient ischemic attack (TIA) do not have DWI evidence of cerebral ischemia. The purpose of this study was to assess the added diagnostic value of perfusion MRI in the evaluation of patients with TIA who have normal DWI findings. MATERIALS AND METHODS: The inclusion criteria for this retrospective study were clinical presentation of TIA at admission with a discharge diagnosis of TIA confirmed by a stroke neurologist, MRI including both DWI and perfusion-weighted imaging within 48 hours of symptom onset, and no DWI lesion...
July 2016: AJR. American Journal of Roentgenology
Dipankar Dutta, Sarah-Jane Bailey
INTRODUCTION: Transient ischaemic attack (TIA) services routinely use ABCD2 scores ascertained by referring clinicians to triage patients. Most ABCD2 validation studies have used ABCD2 scores calculated by stroke-specialist investigators and not referring clinicians. This study aimed to assess the usefulness of referring clinicians' ABCD2 scores in predicting strokes. METHODS: A retrospective study of a TIA clinic cohort from Gloucester, UK, followed up for 4 years from 2010 to 2012...
August 2016: Emergency Medicine Journal: EMJ
Jonas B Lima Filho, Igor de Lima Teixeira, Gustavo Jose Luvizutto, Gabriel Pereira Braga, Rodrigo Bazan
No abstract text is available yet for this article.
February 16, 2016: Neurology
Dipankar Dutta
BACKGROUND: The diagnosis of Transient Ischaemic Attack (TIA) can be difficult and 50-60% of patients seen in TIA clinics turn out to be mimics. Many of these mimics have high ABCD2 scores and fill urgent TIA clinic slots inappropriately. A TIA diagnostic tool may help non-specialists make the diagnosis with greater accuracy and improve TIA clinic triage. The only available diagnostic score (Dawson et al) is limited in scope and not widely used. The Diagnosis of TIA (DOT) Score is a new and internally validated web and mobile app based diagnostic tool which encompasses both brain and retinal TIA...
2016: BMC Neurology
Hiroki Taguchi, Yasuhiro Hasegawa, Kuniaki Bandoh, Hideki Koyasu, Yuukou Watanabe, Kohei Yamashita, Kenji Shimazaki, Hiroshi Shima, Masaaki Miyakawa, Yoshikazu Niwa
BACKGROUND: Japan has the highest number of magnetic resonance imaging units in the world, and citizens can freely choose medical care at any hospital or clinic. We aimed to investigate the triage of patients with suspected transient ischemic attack (TIA) or minor stroke in this unique Japanese healthcare system. METHODS: In this cohort study, patients with suspected TIA or minor stroke (National Institutes of Health Stroke Scale score <4) within 7 days after onset were prospectively enrolled and followed for 1 year...
April 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Bo Song, Lulu Pei, Hui Fang, Lu Zhao, Yuan Gao, Yuanyuan Wang, Song Tan, Yuming Xu
BACKGROUND AND PURPOSE: The risk of stroke after a transient ischemic attack (TIA) for patients with a positive diffusion-weighted image (DWI), i.e., transient symptoms with infarction (TSI), is much higher than for those with a negative DWI. The aim of this study was to validate the predictive value of a web-based recurrence risk estimator (RRE; of TSI. METHODS: Data from the prospective hospital-based TIA database of the First Affiliated Hospital of Zhengzhou University were analyzed...
2015: PloS One
Hans-Christoph Diener, Benedikt Frank
The ABCD2 score was developed to triage patients with transient ischaemic attack according to the risk of experiencing a stroke in the next few hours or days. However, a new systematic review and meta-analysis on the ABCD2 score gives us considerable cause to rethink its value for clinical situations.
October 2015: Nature Reviews. Neurology
Tingting Chu, Weidong Yu, Yingying Wang, Na Guo, Jinting He, Yankun Shao, Jing Mang, Zhongxin Xu
OBJECTIVES: The ABCD2 score has been commonly used to triage patients with transient ischemic attack (TIA) who are at high risk for imminent stroke. However, its accuracy in predicting short-term stroke risk among TIA patients in China remains unclear. METHODS: All eligible studies published up to May 2014 were identified by searching Medline, PubMed, Embase, the China Knowledge Resource Integrated Database (CNKI) and the China Biological Medicine Database (CBM-disc), as well as unpublished articles manually scanned...
2015: Neuro Endocrinology Letters
Sabrina Anticoli, Francesca Romana Pezzella, Claudio Pozzessere, Luca Gallelli, Maria Cristina Bravi, Valeria Caso, Antonio Siniscalchi
BACKGROUND: Acute ischemic lesions on diffusion-weighted magnetic resonance imaging (DWI-MRI) are reliable predictors of recurrent stroke at 90 days. However, to date, limited information on transient ischemic attack (TIA) patients with positive DWI lesions for stroke risk from 1 to 5 years is available. In this study, we evaluated the role of positive DWI lesions and vascular risk factors on stroke, cardiovascular death, and mortality at 90 days (T0), 1 year (T1), and 5 years (T2). Moreover, we also evaluated the association between stroke risk and the presence of DWI lesions...
September 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Joanna M Wardlaw, Miriam Brazzelli, Francesca M Chappell, Hector Miranda, Kirsten Shuler, Peter A G Sandercock, Martin S Dennis
OBJECTIVE: Patients with TIA have high risk of recurrent stroke and require rapid assessment and treatment. The ABCD2 clinical risk prediction score is recommended for patient triage by stroke risk, but its ability to stratify by known risk factors and effect on clinic workload are unknown. METHODS: We performed a systematic review and meta-analysis of all studies published between January 2005 and September 2014 that reported proportions of true TIA/minor stroke or mimics, risk factors, and recurrent stroke rates, dichotomized to ABCD2 score </≥4...
July 28, 2015: Neurology
Milton Sales, Debbie Quain, Dan Lasserson, Christopher Levi, Christopher Oldmeadow, Moyez Jiwa, Mark Parsons, Michelle Russell, Jamie Clarey, Parker Magin
BACKGROUND: The Age, Blood pressure, Clinical features, Duration of symptoms, Diabetes (ABCD2) score can be used to predict early recurrent stroke risk following Transient ischemic attack (TIA). Given that recurrent stroke risk can be as high as 20% in the first week, international guidelines recommend "high-risk" TIAs (ABCD2 >3) be seen by specialist services such as dedicated acute neurovascular clinics within 24 hours. The goal of this study was to examine the associations of both quality of referrals to a specialist acute clinic and of "guideline congruence" of time-to-clinic consultation after TIA/minor stroke...
April 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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