| Can ABCD score predict the need for in-hospital intervention in patients with transient ischemic attacks? | |
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MedLine Citation:
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PMID: 20606814 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: The ABCD(2) score is increasingly being used to triage patients with transient ischemic attack (TIA). Whether the score can predict the need for in-hospital intervention (IHI), other than initiation of antiplatelets and statins, is unknown. AIMS: The ability of the ABCD(2) score to predict IHI would strengthen the rationale to use it as a decision-making tool. We thus conducted this study to investigate the relationship between the ABCD(2) score and IHI. METHODS: We analyzed prospectively collected data from consecutive TIA patients over 12 months. We determined ABCD(2) upon admission and collected the results of in-hospital evaluation, treatments initiated during hospitalization, and follow-up status. We defined IHI as arterial revascularization or anticoagulation required during admission. We used chi-square for trend to examine the association between ABCD(2) and IHI. RESULTS: We studied 121 patients. Fourteen (12%) had small infarcts on diffusion magnetic resonance imaging; 38 (31%) had a new risk factor recognized during admission [hyperlipidemia (n = 9), hypertension (1), diabetes (1), carotid stenosis >/= 50% (16), other arterial occlusive lesions (7), and potential cardioembolic source (4)]. Their percentages increased with higher ABCD(2) scores. However, among 12 patients (10%) with IHI, ABCD(2) score categories were equally distributed (10% in 0-3, 9% in 4-5, and 10% in 6-7; p = 0.8). One patient (0.8%) worsened during hospitalization; none had a stroke during follow-up. CONCLUSION: Patients with an ABCD(2) score </= 3 had an equal chance of requiring IHI as those with a score of 4-7. The decision to admit TIA patients based on the ABCD(2) score alone is not supported by our experience and requires further study. |
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Authors:
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Min Lou; Adnan Safdar; Jonathan A Edlow; Louis Caplan; Sandeep Kumar; Gottfried Schlaug; D Eric Searls; Richard P Goddeau; Magdy Selim |
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Publication Detail:
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Type: Journal Article Date: 2010-05-18 |
Journal Detail:
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Title: International journal of emergency medicine Volume: 3 ISSN: 1865-1380 ISO Abbreviation: Int J Emerg Med Publication Date: 2010 |
Date Detail:
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Created Date: 2010-07-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101469435 Medline TA: Int J Emerg Med Country: England |
Other Details:
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Languages: eng Pagination: 75-80 Citation Subset: - |
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