Comparison of prognostic performance of scores to predict risk of stroke in ED patients with transient ischaemic attack

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To compare the performance of three risk scores (ABCD, ABCD2 and California) in identification of short-term stroke risk in patients with emergency department (ED) diagnosis of transient ischaemic attack. In the retrospective cohort study, information collected included features of clinical risk scores, demographic, clinical and outcome data. The outcome of interest was new stroke occurrence at 2, 7 and 30 days. Data underwent receiver operating curve analyses. Of 326 patients, 17 patients experienced a new stroke within 30 days (4.9%, 95% confidence interval: 2.9–8.0%). C-statistic for high-stroke risk was not significantly different between scores at 2, 7 or 30 days. Using cutoffs of defined risk score cutoffs, the negative predictive values for stroke within 30 days were 97.4% (California), 99.1% (ABCD) and 98.9% (ABCD2), respectively. All three risk scores predict short-term risk of stroke in patients with an ED diagnosis of transient ischaemic attack and could be an effective tool to guide clinical decision making.

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