Addition of Brain Infarction to the ABCD2 Score (ABCD2I) A Collaborative Analysis of Unpublished Data on 4574 Patients

被引：143

作者：

Giles, Matthew F. ^{[1
]}

Albers, Greg W. ^{[4
]}

Amarenco, Pierre ^{[5
,6
]}

Arsava, Murat M. ^{[11
,12
]}

Asimos, Andrew ^{[15
]}

Ay, Hakan ^{[11
,12
]}

Calvet, David ^{[8
]}

Coutts, Shelagh ^{[2
,3
]}

Cucchiara, Brett L. ^{[10
]}

Demchuk, Andrew M. ^{[2
,3
]}

Johnston, S. Claiborne ^{[9
]}

Kelly, Peter J. ^{[14
]}

Kim, Anthony S. ^{[9
]}

Labreuche, Julien ^{[5
,6
]}

Lavallee, Philippa C. ^{[5
,6
]}

Mas, Jean-Louis ^{[8
]}

Merwick, Aine ^{[14
]}

Olivot, Jean Marc ^{[4
]}

Purroy, Francisco ^{[7
]}

Rosamond, Wayne D. ^{[16
]}

Sciolla, Rossella ^{[13
]}

Rothwell, Peter M.

机构：

[1] Univ Oxford, John Radcliffe Hosp, Dept Clin Neurol, Stroke Prevent Res Unit,NIHR Biomed Res Ctr, Oxford OX3 9DU, England

[2] Univ Calgary, Seaman Family Ctr, Dept Clin Neurosci, Calgary, AB, Canada

[3] Univ Calgary, Seaman Family Ctr, Dept Radiol, Calgary, AB, Canada

[4] Stanford Stroke Ctr, Dept Neurol & Neurol Sci, Stanford, CA USA

[5] Bichat Claude Bernard Univ Hosp, Dept Neurol, Paris, France

[6] Bichat Claude Bernard Univ Hosp, Stroke Ctr, Paris, France

[7] Univ Lleida, Dept Neurol, Lleida, Spain

[8] Ctr Hosp St Anne, Dept Neurol, Paris, France

[9] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA

[10] Univ Penn, Med Ctr, Dept Neurol, Philadelphia, PA 19104 USA

[11] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA

[12] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA

[13] Univ Turin, Dept Neurol, Turin, Italy

[14] Mater Univ Hosp, Neurovasc Clin Sci Unit, Dublin, Ireland

[15] Carolinas Med Ctr, Dept Emergency Med, Charlotte, NC 28203 USA

[16] Univ N Carolina, Sch Publ Hlth, Dept Epidemiol, Chapel Hill, NC USA

来源：

STROKE | 2010年 / 41卷 / 09期

关键词：

ABCD(2) score; ABCD(2)I score; infarction; prediction; risk; TIA; TRANSIENT ISCHEMIC ATTACK; EARLY STROKE RISK; TIA; VALIDATION; PREDICT; LESIONS;

D O I：

10.1161/STROKEAHA.110.578971

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-The ABCD system was developed to predict early stroke risk after transient ischemic attack. Incorporation of brain imaging findings has been suggested, but reports have used inconsistent methods and been underpowered. We therefore performed an international, multicenter collaborative study of the prognostic performance of the ABCD(2) score and brain infarction on imaging to determine the optimal weighting of infarction in the score (ABCD(2)I). Methods-Twelve centers provided unpublished data on ABCD(2) scores, presence of brain infarction on either diffusion-weighted imaging or CT, and follow-up in cohorts of patients with transient ischemic attack diagnosed by World Health Organization criteria. Optimal weighting of infarction in the ABCD(2)I score was determined using area under the receiver operating characteristic curve analyses and random effects meta-analysis. Results-Among 4574 patients with TIA, acute infarction was present in 884 (27.6%) of 3206 imaged with diffusion-weighted imaging and new or old infarction was present in 327 (23.9%) of 1368 imaged with CT. ABCD(2) score and presence of infarction on diffusion-weighted imaging or CT were both independently predictive of stroke (n=145) at 7 days (after adjustment for ABCD(2) score, OR for infarction=6.2, 95% CI=4.2 to 9.0, overall; 14.9, 7.4 to 30.2, for diffusion-weighted imaging; 4.2, 2.6 to 6.9, for CT; all P<0.001). Incorporation of infarction in the ABCD(2)I score improved predictive power with an optimal weighting of 3 points for infarction on CT or diffusion-weighted imaging. Pooled areas under the curve increased from 0.66 (0.53 to 0.78) for the ABCD(2) score to 0.78 (0.72 to 0.85) for the ABCD(2)I score. Conclusions-In secondary care, incorporation of brain infarction into the ABCD system (ABCD(2)I score) improves prediction of stroke in the acute phase after transient ischemic attack. (Stroke. 2010; 41:1907-1913.)

引用

页码：1907 / 1913

页数：7

共 26 条

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