Chardoli Mojtaba, Khajavi Alireza, Nouri Mohsen, Rahimi-Movaghar Vafa
Sina Trauma and Surgery Research Center, Tehran University Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013;51(9):611-4.
As a significant number of patients diagnosed with transient ischemic attack (TIA) at emergency department are at risk to develop TIA or cerebral vascular accident (CVA), several attempts have been made to figure out a predictive method to detect those at higher risk of such attacks. We aimed to evaluate the role of ABCD2 scoring which includes age, blood pressure, clinical symptoms, diabetes mellitus, and duration of symptoms in predicting short term outcome of the patients presenting with TIA. One hundred consecutive patients visited between 2009 and 2010 in Hazrat Rasoul Akram Hospital and diagnosed with TIA were enrolled and their ABCD2 scores were registered. The incidence of death, CVA, or TIA during the first week after the attack was recorded. Eleven patients suffered new TIA/CVA after 1 week. Sensitivity and specificity of ABCD2 score for predicting CVA/TIA at cut-off point of 4 were 72.7% and 52.8%, respectively. At the same cut-off point for ABCD2, positive and negative predictive values were 16% and 94 %, respectively. Our results show that although patients with ABCD2 score greater than 4 were more likely to develop recurrent TIA/CVA in short term, those with lesser score still harbour a considerable risk for TIA/CVA. Though ABCD2 as an easily applicable tool is very helpful in management of TIA patients at emergency department, but it should not be the only measure to rely on in our decision making.
由于在急诊科被诊断为短暂性脑缺血发作（TIA）的大量患者有发生TIA或脑血管意外（CVA）的风险，人们已经进行了几次尝试来找出一种预测方法，以检测那些发生此类发作风险较高的患者。我们旨在评估ABCD2评分（包括年龄、血压、临床症状、糖尿病和症状持续时间）在预测TIA患者短期预后中的作用。纳入了2009年至2010年期间在哈兹拉特·拉苏尔·阿克拉姆医院就诊并被诊断为TIA的连续100例患者，并记录了他们的ABCD2评分。记录了发作后第一周内的死亡、CVA或TIA发生率。11例患者在1周后发生了新的TIA/CVA。ABCD2评分在截断值为4时预测CVA/TIA的敏感性和特异性分别为72.7%和52.8%。在ABCD2的相同截断值下，阳性预测值和阴性预测值分别为16%和94%。我们的结果表明，虽然ABCD2评分大于4的患者在短期内更有可能发生复发性TIA/CVA，但评分较低的患者仍有相当大的TIA/CVA风险。虽然ABCD2作为一种易于应用的工具在急诊科TIA患者的管理中非常有帮助，但它不应是我们决策中唯一依赖的措施。
