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Review: 3 prediction rules, particularly ABCD, identify ED patients who can be discharged with low risk of stroke after TIA

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Question

In patients with transient ischaemic attack (TIA), can physicians in the emergency department (ED) reliably use a clinical prediction rule to determine which patients can be discharged because their risk of stroke is low (1–2%)?

Review scope

Included studies reported either the derivation or validation of clinical prediction rules for determining risk of stroke within 7 days after TIA in adults. Exclusion criteria were non-acute care setting and sample of patients with known history of TIA. Outcome was risk of stroke in relation to prediction rule scores.

Review methods

PubMed, EMBASE/Excerpta Medica, and DARE were searched for English-language studies. 5 studies were included. 2 studies were derivation cohorts (California rule and ABCD2 rule), 2 were validation studies (ABCD rule), and 1 was a derivation and validation study (ABCD rule). Levels of evidence were assigned (1  =  high to 4  =  low) …

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