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Risk score identifies patients most vulnerable to a stroke within 90 days of a transient ischaemic attack

New stroke predictor tool for GPs

GPs will be able to focus care at patients at greatest risk of a stroke using a new prediction tool, its creators claim.

The tool identifies those patients who are most vulnerable to a stroke within 90 days of a transient ischaemic attack.

Patients with the highest scores – over-60s with risk factors including high blood pressure and focal weakness – had a 23 per cent risk of a stroke in the three months after the initial event.

Writing in the latest issue of The Lancet, the authors described the new risk score – called ABCD2 – as 'a more accurate predictor' than previous models. They claimed it would become a new standard for use in clinical care.

Professor Peter Rothwell, one of the researchers on the study and director of the Oxford stroke prevention unit, said the risk tool would be particularly useful for GPs.

'It is very much aimed at primary care – so that GPs can triage patients with transient ischaemic attack when they present.

'This is particularly useful in the UK because hospital services for attacks are often very slow and many patients have strokes on the waiting list.

'This sort of score will help GPs to decide which of their patients are at particularly high risk of stroke and therefore need to been referred as 'very urgent' or 'emergency' cases.'

The score was assessed in 63 GP surgeries in the UK and 16 hospital emergency departments and outpatient clinics in the US.

It plugs in a series of risk

factors predicting subsequent stroke – including diabetes, which increases the 90-day risk 1.7-fold, and focal weakness, which raises risk 3.2-fold (see right).

Dr Brendan Boyle, stroke lead for Huntingdonshire PCT and a GP in Warboys, Cambridgeshire, said the tool would be useful for encouraging non-compliant patients to manage their risk factors.

'Predicting a high score might help GPs to convince less compliant patients to be more co-operative.

'And by reducing their blood pressure, improving their diabetic control and stopping smoking, that will be reflected in their risk score.'

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