Predictive value of ABCD2 scale in cerebral infarction and death events after transient ischemic attack: a cohort medium-term follow-up study

Abstract

Objective To evaluate the predictive value of ABCD2 scoring system in cerebral infarction and death events in the medium-term after transient ischemic attack (TIA) of Chinese population. Methods One hundred and seventy-nine patients with TIA having complete clinical data,admitted to our hospital from January 2008, were chosen in our perspective study. The ABCD2 scale was applied to all the patients and used to observe the 18-month cerebral infarction risk events; according to these data, patients after TIA were divided into cerebral infarction group and non-cerebral infarction group; To the end of 18 months, according to the death event, the patients were divided into survival group and death group. The age, level of blood pressure, clinical features, duration of symptoms and history of diabetes were collected and compared between each 2 groups; the cutofflevel of ABCI2 scale for anticipating cerebral infarction risk and mortality was evaluated according to receiver operating characteristic (ROC) curve. Results Among the studied 179 patients, 52 patients appeared cerebral infarctions within 18 months of TIA; patients in the cerebral infarction group had significantly higher percentage of patients with blood pressure ≥ 140/90 mm Hg (86.5％), unilateral weakness (42.3％),duration of symptoms ≥60 minutes (55.8％), or duration of symptoms 10 to 59 minutes (40.4％), and diabetes (80.8％) as compared with patients in the non-cerebral infarction group (P＜0.05). According to the ROC curve, area under curve was 0.874 of ABCD2 scale for anticipating cerebral infarction risk, 95％confidence interval (CI) was 0.817-0.931 and the cutoff level of ABCD2 scale for anticipating medium-term cerebral infarction risk was 4.5. Among the studied 179 patients, 35 patients died within 18months of TIA; no significant difference in the scores of ABCD2 scale was noted between survival group and death group (P＞0.05); according to ROC curve, area under curve was 0.492 of ABCD2 scale for anticipating mortality, and 95％ CI was 0.389-0.596. Conclusion ABCD2 scale has predictive value in cerebral infarction event, while not in death event in the medium-term of TIA. Key words: ABCD2 scale; Transient ischemic attack; Cerebral infarction; Prediction