Predicting Stroke Risk After TIA

Ivanhoe Newswire
Friday, January 26, 2007; 12:00 AM

(Ivanhoe Newswire) -- If you've had a transient ischemic attack, what doctors commonly call a mini-stroke or TIA, you know you are at higher risk of having a full-blown stroke.

But how high is the risk, and what should your doctor do about it? A couple of prediction scores have helped physicians determine who is most at risk for another stroke within the next seven days or the next three months following a TIA, but until now they haven't had a very good way to tell who is mostly likely to have a stroke within the first two days -- and that's the most crucial time because that's when doctors need to decide what kind of preventive measures to adopt.

University of California, San Francisco, researchers combined the two existing stroke scores to come up with a new unified score that proved effective in establishing stroke risk within the first two days. With this new tool, doctors should be better able to decide whether someone who has had a mini-stroke should be hospitalized for more intense treatment, or sent home and monitored on an outpatient basis.

Reports study author S. Claiborne Johnston, M.D., "We did the study because there continues to be a lot of confusion and inconsistency among physicians treating patients with TIA. Some admit nearly all such patients to the hospital while others monitor in the outpatient setting. This new score should be very useful in deciding who should come into the hospital right away."

The new score, which has been dubbed ABCD2, will definitely have a direct affect on patient care, agrees fellow investigator Walter N. Kernan, from Yale University School of Medicine in New Haven, Conn. In an accompanying commentary, he writes, "ABCD reminds us that an effective doctor 'deals in futures.' He or she understands the course of a symptom or disease with sufficient confidence to support rational, cost-effective decisions about investigation and treatment."

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SOURCE: The Lancet, 2007;369:283-297