Transient Ischemic Attack (TIA) Prognosis Calculator

Determines the likelihood of a stroke episode based on five independent risk factors.

Information about the factors involved and about TIA symptoms can be found in the text below the tool.


The transient ischemic attack (TIA) prognosis calculator determines the 90-day risk of stroke after a TIA episode, based on five independent factors (age, diabetes diagnosis, TIA duration, weakness and speech impairment)

The tool also prognoses short term risk of other adverse events such as recurrent TIA, admission for cardiovascular conditions or death.


Depending on the number of risk factors that the patient presents, the associated risk of adverse events changes as follows: 

Number of present risk factors Risk of stroke and/or adverse events
0 No risk
1 3%
2 7%
3 11%
4 15%
5 34%

1

Age greater than 60 years

2

Diabetes mellitus

3

TIA duration greater than 10 min

4

Weakness during TIA

5

Speech impairment

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


 

Prognosis method

This is a health tool that prognoses short term (90-day) risk of adverse events in patients who have just suffered a transient ischemic attack.

These events include stroke, recurrent TIA, admission for cardiovascular conditions or death.

Depending on the number of risk factors present, the risk of adverse events changes:

Number of present risk factors Risk of stroke /or adverse events
0 No risk
1 3%
2 7%
3 11%
4 15%
5 34%

This prognosis method is based on a study on a cohort of 1,707 patients with a mean age of 72 years, in which most subjects presented risk factors for hypertension and diabetes.

The main limitation of the study is given by its focus on patients over 60, thus the result cannot offer relevant prediction for younger patients, for example in cases of non-atherosclerotic TIA, or posterior circulation TIA.

The five independent factors associated with stroke risk and their associated statistic values are introduced in the table below:

Risk factors Odds ratio 95% CI P
Age >60 years 1.8 1.1-2.7 =.01
Diabetes mellitus 2 1.4-2.9 <.001
TIA duration >10 min 2.3 1.3-4.2 =.005
Weakness during TIA 1.9 1.4-2.6 <.001
Speech impairment 1.5 1.1-2.1 =.01

In 2008, a new score that aims to prognosticate stroke risk was published, the ABCD2. The two scores have been validated in several studies and have shown similar performance, with the ABCD2 performing slightly better.

 

TIA symptoms and stroke prediction

A transient ischemic attack is a condition that is rapid in occurrence and succession and that is caused by a temporary disruption of blood flow in an area of the brain, which in turn manifests through a cohort of neurological symptoms, such as numbness or speech impairment.

This episode is often succeeded by an ischemic stroke, thus correct and timely diagnosis can prove vital.

TIA symptoms are similar to those of a stroke and include:

■ Unilateral or bilateral numbness in limbs;

■ Facial drop on one side;

■ Visual or speech impairment;

■ Weakness.

Symptoms can resolve after a few minutes, a few hours or within 24 hours. By definition, a patient with TIA does not have any residual symptoms from the primary event, therefore, treatment focuses on reducing the risk of stroke and in resolving the underlying cause of the ischemic episode. A second ischemic event can cause permanent disability.

The most common risk factors for TIA and stroke are:

■ Hypertension;

■ Atrial fibrillation;

■ High cholesterol;

■ Diabetes;

■ Obesity;

■ Alcoholism;

■ Sedentarism.

The treatment of patients with TIA varies between in-hospital and admission. Stroke risk is highest within the first few days after a TIA and often, brain and vessel imaging improves prediction.

With the implementation of a generally accepted assessment method of stroke risk factors, patients would benefit from a standardization of care, that could take into account short-term prognosis.

 

References

1. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA. 2000; 284(22):2901-6.

2. Kernana WK. Stroke after transient ischaemic attack: dealing in futures. Lancet. 2007; 369:251-252.

3. Lemmens R, Smet S, Thijs VN. Clinical Scores for Predicting Recurrence After Transient Ischemic Attack or Stroke: How Good are They? Stroke. 2013; 44:1198-1203.


App Version: 1.0.1

Coded By: MDApp

Specialty: Neurology

System: Nervous

Objective: Risk Prediction

Type: Calculator

No. Of Items: 5

Article By: Denise Nedea

Published On: June 20, 2017 · 08:17 AM

Last Checked: June 20, 2017

Next Review: June 20, 2018