The Journal of Emergency Medicine
Volume 36, Issue 2 , Pages 194-200 , February 2009

Post-Transient Ischemic Attack Early Stroke Stratification: The ABCD2 Prognostic Aid

  • Christopher R. Carpenter, MD, MSC, FAAEM

      Affiliations

    • Washington University School of Medicine in St. Louis, St. Louis, Missouri
  • ,
  • Samuel M. Keim, MD, MS

      Affiliations

    • Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, Arizona
    • Corresponding Author InformationReprint Address: Samuel M. Keim, md, ms, Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ 85724-5057
  • ,
  • John Crossley, MD, CCFP(EM), FRCP(C)

      Affiliations

    • Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Jeffrey J. Perry, MD, MSC, CCFP(EM)

      Affiliations

    • Department of Emergency Medicine, University of Ottawa/Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
  • ,
  • Best Evidence in Emergency Medicine Investigator Group

      Affiliations

    • Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada

Received 21 November 2007 ,Revised 4 March 2008 ,Accepted 26 March 2008.

References 

  1. Kleindorfer D, Panagos P, Pancioli A, et al. Incidence and short-term prognosis of transient ischemic attack in a population-based study. Stroke. 2005;36:720–723
  2. Rothwell PM, Warlow CP. Timing of TIAs preceding stroke: time window for prevention is very short. Neurology. 2005;64:817–820
  3. Giles MF, Rothwell PM. Risk of stroke after early transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2007;6:1063–1072
  4. Calvet D, Lamy C, Touze E, Oppenheim C, Meder JF, Mas JL. Management and outcome of patients with transient ischemic attack admitted to a stroke unit. Cerebrovasc Dis. 2007;24:80–85
  5. Cucchiara BL, Messe SR, Taylor RA, et al. Is the ABCD score useful for risk stratification of patients with acute transient ischemic attack?. Stroke. 2006;37:1710–1714
  6. Kennedy J, Hill MD, Ryckborst KJ, Eliasziw M, Demchuk AM, Buchan AM. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol. 2007;6:961–969
  7. Lavallee PC, Meseguer E, Abboud H, et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol. 2007;6:953–960
  8. Ross MA, Compton S, Medado P, Fitzgerald M, Kilanowski P, O'Neil BJ. An emergency department diagnostic protocol for patients with transient ischemic attack: a randomized controlled trial. Ann Emerg Med. 2007;50:109–119
  9. Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJ. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet. 2004;363:915–924
  10. Rothwell PM, Giles MF, Chandratheva A, et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet. 2007;370:1432–1442
  11. Giles MF, Rothwell PM. Substantial underestimation of the need for outpatient services for TIA and minor stroke. Age Ageing. 2007;36:676–680
  12. Johnston SC, Smith WS. Practice variability in management of transient ischemic attacks. Eur Neurol. 1999;42:105–108
  13. Nguyen-Huynh MN, Johnston SC. Is hospitalization after TIA cost-effective on the basis of treatment with tPA?. Neurology. 2005;65:1799–1801
  14. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA. 2000;284:2901–2906
  15. Rothwell PM, Giles MF, Flossmann E, et al. A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack. Lancet. 2005;366:29–36
  16. Sciolla R, Melis F SINPAC. Rapid identification of high-risk transient ischemic attacks (prospective validation of the ABCD score). Stroke. 2008;39:297–302
  17. Tsivgoulis G, Spengos K, Manta P, et al. Validation of the ABCD score in identifying individuals at high early risk of stroke after a transient ischemic attack: a hospital-based case series study. Stroke. 2006;37:2892–2897
  18. Johnston SC, Rothwell PM, Nguyen-Huynh MN, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet. 2007;369:283–292
  19. McGinn TG, Guyatt GH, Wyer PC, Naylor CD, Stiell IG, Richardson WS. Users' guides to the medical literature: XXII: how to use articles about clinical decision rules (Evidence-Based Medicine Working Group). JAMA. 2000;284:79–84
  20. Feinstein A. Clinimetrics. New Haven, CT: Yale University Press; 1987;
  21. Laupacis A, Sekar N, Stiell IG. Clinical prediction rules (A review and suggested modifications of methodological standards). JAMA. 1997;277:488–494
  22. Lee TH. Evaluating decision aids: the next painful step. J Gen Intern Med. 1990;5:528–529
  23. Stiell IG, Wells GA. Methodologic standards for the development of clinical decision rules in emergency medicine. Ann Emerg Med. 1999;33:437–447
  24. Wasson JH, Sox HC, Neff RK, Goldman L. Clinical prediction rules (Applications and methodological standards). N Engl J Med. 1985;313:793–799
  25. Wigton RS, Connor JL, Centor RM. Transportability of a decision rule for the diagnosis of streptococcal pharyngitis. Arch Intern Med. 1986;146:81–83
  26. Harrell FE, Califf RM, Pryor DB, Lee KL, Rosati RA. Evaluating the yield of medical tests. JAMA. 1982;247:2543–2546

PII: S0736-4679(08)00480-0

doi: 10.1016/j.jemermed.2008.04.034

The Journal of Emergency Medicine
Volume 36, Issue 2 , Pages 194-200 , February 2009