The existing prognostic scores for early-risk stroke prediction after transient ischaemic attack (TIA)* have been validated and refined to develop a unified score that is more predictive than previous methods, according to an Article published in this week's issue of The Lancet.
About 240,000 TIAs are diagnosed every year in the USA, and about 70,000 in the UK. Recent studies have shown that 4-20% of these patients will have a stroke within 90 days of a TIA, and half within the first two days. Identification of those at highest and lowest risk of stroke in the first days and weeks after a TIA would allow appropriate use of costly secondary prevention strategies, including hospital admission. However, it has not been possible to estimate individual risk with sufficient accuracy to guide clinical decisions. Two prognostic scores for estimating short-term risk of stroke after TIA have been proposed - ABCD score and the California score - they estimate the risk for stroke within 7 days or 90 days, respectively, after presentation with TIA. However, the 2-day risk is often most relevant for decisions about necessity of urgent evaluation and observation.