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Tool May Predict Additional Strokes Over Short Term

Recurrence risk estimator could help direct patients to proper management following stroke

THURSDAY, Dec. 17 (HealthDay News) -- A tool called the recurrence risk estimator at 90 days (RRE-90), which includes clinical and imaging factors that are usually available to clinicians when patients are admitted, appears useful in predicting 90-day risk of recurrent stroke, according to research published online Dec. 16 in Neurology.

Hakan Ay, M.D., of Massachusetts General Hospital in Boston, and colleagues analyzed data from 1,458 consecutive patients admitted shortly after ischemic stroke. The authors created models using clinical or clinical-plus-imaging variables to compare differences between patients who did or did not have an additional stroke.

The researchers found that the RRE-90 score, which incorporated clinical and imaging information, showed good discrimination (area under the ROC curve, 0.80) and calibration for predicting 90-day risk of recurrent stroke. The RRE-90 score also offered good discrimination for predicting 14-day risk of stroke recurrence (area under the ROC curve, 0.80).

"The RRE-90 -- as any other prediction score -- will ultimately be judged on its clinical impact and on the improvement of patient management. In this context, the findings presented by Ay and colleagues clearly emphasize the need for a detailed diagnostic workup in patients with acute stroke as the strongest predictors are those revealed by additional diagnostic procedures," write the authors of an accompanying editorial.

Several co-authors reported relationships with pharmaceutical and medical device companies, journals, and patents. An editorial author also reported financial and consulting relationships with medical companies and associations.

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