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Scoring Tool Predicts Seven-Day Stroke Risk After TIA

FRIDAY, Feb. 19, 2021 -- The Canadian Transient Ischemic Attack (TIA) Score effectively stratifies seven-day stroke risk among emergency department patients with TIA, according to a study published online Feb. 4 in The BMJ.

Jeffrey J. Perry, M.D., from University of Ottawa in Ontario, Canada, and colleagues conducted a validation study of the previously derived Canadian TIA Score to stratify subsequent stroke risk among 7,607 consecutive patients seen for TIA in 13 Canadian emergency departments over five years.

The researchers found that 1.4 percent of patients had a subsequent stroke within seven days, 1.1 percent had carotid endarterectomy/carotid artery stenting within seven days, and nine had both. Compared with the ABCD2 score (area under the curve, 0.60) or ABCD2i score (area under the curve, 0.64), the Canadian TIA Score (area under the curve, 0.70) more accurately stratified the risk for stroke, carotid endarterectomy/carotid artery stenting, or both within seven days as low (risk, ≤0.5 percent; interval likelihood ratio, 0.20; 95 percent confidence interval, 0.09 to 0.44), medium (risk, 2.3 percent; interval likelihood ratio, 0.94; 95 percent confidence interval, 0.85 to 1.04), and high (risk, 5.9 percent; interval likelihood ratio, 2.56; 95 percent confidence interval, 2.02 to 3.25). Subsequent stroke risk results were similar regardless of carotid endarterectomy/carotid artery stenting within seven days.

"Incorporating this validated risk estimate into management plans should improve early decision making at the index emergency visit regarding benefits of hospital admission, timing of investigations, and prioritization of specialist referral," the authors write.

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Posted: February 2021