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Stroke Risk Check Could Save Lives

Posted on: Tuesday, 5 July 2005, 09:01 CDT

Strokes could be predicted and prevention improved by use of a risk score developed by scientists. The research could change the way patients who have suffered a 'mini-stroke' - also known as Transient Ischaemic Attacks (TIAs) - are assessed and treated.

TIAs are similar to strokes but usually last only a few minutes. But as many as one in five people who have a TIA will go on to have a major stroke within a month - the greatest risk is within the first 72 hours.

The Oxford-based Stroke Prevention Research Unit has identified four factors that could predict this risk - the age of patients, blood pressure, the clinical features patients present with and the duration of TIA symptoms.

These predictive factors have been combined to create an ABCD score as a way of quantifying this risk.

The risk of stroke within seven days of TIA was over 30% in patients with a high ABCD score, whereas there were no early strokes in patients with low scores.

Professor Peter Rothwell, the unit's director, said, 'The ABCD score can be used in routine clinical practice to identify high- risk individuals who need emergency investigation and treatment.'

Current clinical guidelines recommend that TIA patients be assessed and treated at specialist clinics within seven days of their symptoms, but in most parts of the UK patients face delays of two weeks or more for appointments.

The researchers found that most strokes that occurred in the first few days and weeks after a TIA occurred in patients who had been referred to a hospital clinic for investigation but had yet to be seen.

Prof Rothwell added, 'Current guidelines on the urgency with which TIA patients are investigated need to be revised. These improvements would not require an increase in funding and could be achieved simply by more effective use of existing resources. However, changes in health service policy would be needed for this to be achieved.'

Joe Korner, director of communications at The Stroke Association, said, 'All too often TIAs are ignored. It is essential that all TIAs are diagnosed quickly so that patients can be assessed and immediately started on the most appropriate course of treatment.'

Source: Western Mail

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