Stroke Unit, Department of Neurological Disorders, Santa Chiara Hospital, Trento, Italy.
J Neurol Sci. 2011 Apr 15;303(1-2):85-9. doi: 10.1016/j.jns.2011.01.005. Epub 2011 Jan 26.
ABCD2 score identifies high-risk TIAs but its validity in different countries and hospitals is unknown. Doubts remain also about the role of diagnostic work up for patients with TIAs in the emergency department. The present study was undertaken to confirm the usefulness of ABCD2 score in the emergency department of Trento Hospital and to evaluate if other exams (carotid ultrasound or CT scan) commonly performed in TIA patients are helpful. We retrospectively analysed discharge diagnosis of around 120,000 patients seen at the first aid of Trento Hospital over a 28 month period. ABCD2 score, carotid ultrasound and CT scan were recorded and were correlated with recurrence of stroke at different time points (mean follow-up period of 11.4 months) in all patients with TIA. We identified 965 patients with focal neurologic deficit and 502 could be classified as TIA. An ischemic stroke recurred in 30 patients at the end of the follow-up (30% in the first two days). ABCD2 score confirmed its value. A significant carotid stenosis (>70%) was an independent risk factor for stroke at any time point. Our study confirms the role of ABCD2 in a large Italian cohort of TIA patients but also suggests the importance of performing a carotid ultrasound as soon as possible.
ABCD2 评分可识别高危 TIA，但它在不同国家和医院的有效性尚不清楚。对于在急诊科就诊的 TIA 患者，诊断检查的作用仍存在疑问。本研究旨在确认 ABCD2 评分在特伦托医院急诊科的有用性，并评估颈动脉超声或 CT 扫描等常用于 TIA 患者的其他检查是否有帮助。我们回顾性分析了特伦托医院急救科在 28 个月期间接诊的约 12 万名患者的出院诊断。记录了 ABCD2 评分、颈动脉超声和 CT 扫描，并将其与所有 TIA 患者在不同时间点（平均随访 11.4 个月）的卒中复发情况进行了相关性分析。我们共发现 965 名有局灶性神经功能缺损的患者，其中 502 名可被归类为 TIA。在随访结束时，30 名患者发生缺血性卒中复发（前 2 天内 30%）。ABCD2 评分证实了其价值。颈动脉狭窄程度>70%是任何时间点发生卒中的独立危险因素。本研究证实了 ABCD2 在意大利 TIA 患者大型队列中的作用，但也提示了尽快进行颈动脉超声检查的重要性。
