The Canadian TIA score can help to stratify a patient for risk of cerebrovascular disease following a transient ischemic attack (TIA). The authors are from multiple institutions in Canada.
Patient selection: transient ischemic attack
Parameters:
(1) previous TIA in lifetime
(2) duration of symptoms
(3) past history of carotid stenosis
(4) receiving antiplatelet therapy
(5) history of gait disturbance
(6) history of unilateral weakness
(7) history of vertigo
(8) initial diastolic blood pressure at triage in mm Hg
(9) dysarthria or aphasia (prior to or during exam)
(10) atrial fibrillation on ECG
(11) cerebral infarction (old or new) on head CT
(12) platelet count in 10^9/L
(13) blood glucose in mmol/L
|
Parameter |
Finding |
Points |
|
previous TIA in lifetime |
no |
2 |
|
|
yes |
0 |
|
duration of symptoms |
< 10 minutes |
0 |
|
|
>= 10 minutes |
2 |
|
history of carotid stenosis |
no |
0 |
|
|
yes |
2 |
|
antiplatelet therapy |
no |
0 |
|
|
yes |
3 |
|
history of gait disturbance |
no |
0 |
|
|
yes |
1 |
|
history of unilateral weakness |
no |
0 |
|
|
yes |
1 |
|
history of vertigo |
no |
0 |
|
|
yes |
-3 |
|
diastolic blood pressure |
< 110 mm Hg |
0 |
|
|
>= 110 mm Hg |
3 |
|
dysarthria or aphasia |
no |
0 |
|
|
yes |
1 |
|
atrial fibrillation |
no |
0 |
|
|
yes |
2 |
|
cerebral infarct |
no |
0 |
|
|
yes |
1 |
|
platelet count |
< 400 * 10^9/L |
0 |
|
|
>= 400 * 10^9/L |
2 |
|
glucose |
< 15 mmol/L |
0 |
|
|
>= 15 mmol/L |
3 |
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: -3
• maximum score: 23
• The higher the score the greater the risk of subsequent stroke and/or carotid revascularization.
|
Total Score |
Risk Group |
Observed Risk |
|
<= 3 |
low |
0.2% |
|
4 to 8 |
medium |
1.5% |
|
>= 9 |
high |
2.7% |
Performance:
• The area under the ROC curve is 0.70.
Specialty: Neurology
