Johnston et al evaluated the short term (within 90 days) risk for stroke in patients presenting to the Emergency Department with a Transient Ischemic Attack (TIA). Patients with TIAs have a susbstantial short term risk for stroke, hospitalization, cardiovascular events and death. The presence of certain risk factors can identify patients who may benefit from more aggressive evaluation and treatment. The authors are from 3 hospitals (UCSF, VAMC, KPNC) in San Francisco.
Factors determined by logistic regression analysis:
(1) age
(2) diabetes mellitus
(3) duration of episode
(4) weakness during episode
(5) speech impairment during episode
|
Factor |
Odds Ratio |
95% CI |
|
age of the patient > 60 years |
1.8 |
1.1 – 2.7 |
|
diabetes mellitus present |
2.0 |
1.4 – 2.9 |
|
duration of episode > 10 minutes |
2.3 |
1.3 – 4.2 |
|
weakness with episode |
1.9 |
1.4 – 2.6 |
|
speech impairment with episode |
1.5 |
1.1 – 2.1 |
|
Factor |
Finding |
Points |
|
age of the patient |
<= 60 years |
0 |
|
|
> 60 years |
1 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
1 |
|
duration of episode |
<= 10 minutes |
0 |
|
|
> 10 minutes |
1 |
|
weakness with episode |
absent |
0 |
|
|
present |
1 |
|
speech impairment with episode |
absent |
0 |
|
|
present |
1 |
number of risk factors =
= SUM(points for risk factors)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score, the greater the short term risk for stroke.
|
Number of Risk Factors |
Stroke Within 90 Days |
|
0 |
0% |
|
1 |
3% |
|
2 |
7% |
|
3 |
11% |
|
4 |
15% |
|
5 |
34% |
Purpose: To identify risk factors for stroke within 90 days for patients with transient ischemic attack (TIA).
Specialty: Neurology
Objective: risk factors
ICD-10: I60, I61, I62, I63, I64,
