Early Prediction with ABCD3-I Score for Stroke Risk after Transient Ischemic Attack
ZHANG Xiao-Dan;QIN Wei;HU Wen-Li.
2012, 7(01):
23-28.
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Objective To explore the ability of ABCD3-I score in predicting the early risk of stroke aftertransient ischemic attack(TIA).Methods We collected in 186 consecutive patients with TIA who had diffusion weighted imagingmagneticresonance imaging(DWI-MRI) within 48 hours of symptom onset. According toABCD3-I score, we separated into low risk group, mid risk group and high risk group. We observedthe incidence of stroke within 7 days and 90 days after onset of TIA and the positive values ofABCD2 score and ABCD3 score and ABCD3-I score were compared. Predict risk factors of strokeoccurrence at early time intervals after onset of TIA by multivariate logistic regression model.Results There were no patient in low risk group(score0-4) had stroke within 7 days, 3.0% hadstroke in mid risk group(score 4-7), and 33.8% in high risk group(score 8-13), There were nopatient in low risk group had stroke within 90 days, 6.0% had stroke in mid risk group, and52.3% in high risk group. Stroke occurrence within 7 days and 90 days after TIA were higher inhigh risk group compared with mid risk group and low risk group respectively(P <0.01, P <0.01).Stroke occurrence within 90 days after TIA were higher in mid risk group compared with low riskgroup(P <0.01), but there was no significant difference between low risk group and mid risk groupwithin 7 days after TIA(P ﹥0.05). Logistic regression model showed that recurrent TIA predictedstroke within 90 days(OR =4.307, 95%CI 2.317~8.005, P ﹤0.01), DWI hyperintensity predictedstroke within 90 days(OR =1.102, 95%CI 27.719~223.344, P ﹤0.01). Carotid stenosis predictedstroke within 90 days(OR=7.800, 95%CI 2.075~29.319, P ﹦0.005). When the occurrences of strokewere observed in 7 days, the area under the curve of ABCD2, ABCD3, ABCD3-I were 0.627, 0.842and 0.900. The 7-day positive predictive values were 25.3%, 68.4% and 81%. In 90 days, the areasunder the curve were 0.608, 0.796 and 0.860; The 90 day's positive predictive values were 21.5%,59.1% and 73%.Conclusions When ABCD3-I score 8(high risk group), stroke occurrence within 7 days and 90days after TIA were higher, When ABCD3-I score 4(mid and high risk group), stroke occurrencewithin 90 days after TIA were higher, the risk of stroke was correlated with recurrent TIA, carotidstenosis, and DWI hyperintensity after TIA. The predictive accuracy of the ABCD3-I score isevidently superior to others.
