Prediction Models Of Early Stroke Risk After Transient Ischemic Attack: The Evaluation And Improvement

Objective:To evaluate the ability of four models (ABCD,ABCD2,ABCD+LDL and ABCD2+LDL) in predicting early stroke risk after transient ischemic attack and seclect the one which has the most predictive accuracy.Methods:165 TIA patients were evaluated according to ABCD score,ABCD2 score,ABCDL score and ABCD2L score. The occurrences of cerebral infarction were observed in 2 days and 7 days. We dealt with all the data with the SPSS 17.0statistics analysis software to evaluate the ability of these methods in predicting early stroke risk after TIA and seclect the most advanced one. According to this score,TIA patients were divided into three groups. And we compared their difference of occurrence of stroke among these groups.Results:The two-day risk of stroke was 13.33% and the seven-day risk of stroke was 20.0% in 165 patients. When the occurrences of cerebral infarction were observed in two days, the AUCs(95%CI) of ABCD,ABCD2,ABCDL and ABCD2L were 0.72(0.62～0.83),0.76(0.66～0.86),0.78(0.69～0.87) and 0.80 (0.72～0.89) separately. Observed in seven days, the AUCs(95%CI) of ABCD,ABCD2,ABCDL and ABCD2L were 0.69(0.59～0.79),0.73(0.64-0.83),0.76(0.67～0.85) and 0.79(0.70～0.88)separately. And comparing with other scores, the area under the curve of ABCD2L was the biggest. According to this ABCD2L score, the patients were divided into three groups:low-risk group(score 0-2), moderate-risk group(score 3-5) and high-risk group(score 6-8). The 2-day risk of stroke was 0% in low-risk group,7.8%in moderate-risk group,31.1%in high-risk group(P<0.05). The 7-day risk of stroke was 0% in low-risk group,12.6% in moderate-risk group,44.4%in high-risk group (P＜0.05).Conclusions:ABCD score and ABCD2 score are both effective to predict the short-term stroke risk after TIA, moreover,the predictive accuracy of the ABCD2 score is higher than that of ABCD score.Combining the LDL factor to ABCD and ABCD2 score, we compare these scores and found that the predictive accuracy of the ABCD2L is the highest.And according to the risk stratification of ABCD2L score,we can identify individuals at high early risk of stroke after TIA. Moreover,in predicting early stroke risk,the ABCD2L score is more sensitive than the ABCD2 score.