Clinical Prediction Rules to Stratify Short-Term Risk of Stroke Among Patients Diagnosed in the Emergency Department With a Transient Ischemic Attack

There is a clear and predictable increase in stroke risk with an increased number of risk factors in all 3 clinical prediction rules. The ABCD rule has been well validated and is most likely to be predictive and clinically useful. Patients with an ABCD score of less than 4 are clearly at lower risk of stroke within 2 and 7 days of presentation (<2%) and may be candidates for discharge home with urgent outpatient evaluation. Future research in this area should involve impact analysis of the ABCD rule and further validation of the California and ABCD2 rules in other populations.