Stroke: a better way to predict a second attack
Researchers at Harvard Medical School and Massachusetts General Hospital have reported in Neurology that they have developed a web-based tool that predicts more efficiently whether or not a stroke victim will have a second attack within 90 days of the first.
They examined data for about 1,458 people who experienced an ischaemic stroke and were admitted to the hospital within 72 hours.
Participants gave information about their medical history and underwent brain scans. After a three-month follow-up involving 806 of the participants, 60 strokes had occurred, 30 of them occurring within 14 days of the first stroke. The study found that the risk of recurrent stroke was 2.6% at 14 days and 6% at 90 days.
The researchers developed what they have called the Recurrence Risk Estimator at 90 days (RRE-90) score to calculate a person's risk of having another stroke within three months by looking at risk factors for stroke, such as history of mini-stroke, or transient ischaemic attack, age and the type of first stroke the person experienced, along with information from brain scans.
It seems that the higher the score, the more likely it is that a patient will experience a second stroke. The 90-day risk was about 40 times greater in people with four or more stroke risk factors than in people without any risk factors. The study found that more than 96% of patients who developed a second stroke showed signs of one or more risk factor.
It also found that long-term predictors of stroke (eg, smoking, diabetes, hypertension) did not predict short-term strokes.
The researchers warn that the accuracy of the tool still needs to be confirmed before it can be implemented for general use.
Published: 15 Feb 2010