Validation of the ABCD3-I score to predict stroke risk after transient ischemic attack

Abstract

Background and purpose: The Age, Blood Pressure, Clinical Features, Duration, and Diabetes plus Dual TIA (ABCD(3)-I) score is recommended to predict the risk of early stroke after transient ischemic attack. The aim of this study was to validate the predictive value of the ABCD(3)-I score and compare the accuracy of the Age, Blood Pressure, Clinical Features, Duration, and Diabetes (ABCD(2)) and ABCD(3)-I scores in a Chinese population.

Methods: Data were prospectively collected from patients who had transient ischemic attack, as defined by the World Health Organization time-based criteria. ABCD(2) and ABCD(3)-I scores were available within 7 days of the index transient ischemic attack. The predictive outcome was stroke occurrence at 90 days. The receiver-operating characteristic curves were plotted, and the C statistics were calculated as a measure of predictive ability. The comparison of the area under the receiver-operating characteristic curve (area under the curve) was performed by Z test.

Results: Among 239 eligible patients, the mean age was 57.4±13.32 years, and 40.2% of the patients were women. The incidence of stroke at 90 days was 12.1%, which ranged from 0% in patients with lower ABCD(3)-I scores (0-3) to 40.91% in those with higher scores of 8 to 13 (P for trend <0.0001). Moreover, the C statistic of ABCD(3)-I scores (0.825; 95% confidence interval, 0.752-0.898) was statistically higher than that of ABCD(2) scores (0.694; 95% confidence interval, 0.601-0.786; P<0.001).

Conclusions: The ABCD(3)-I score had a higher predictive value than the ABCD(2) score for assessing the risk of early stroke after transient ischemic attack in a Chinese population.