Evaluation of the ESRS and SPI-II scales for short-term prognosis of minor stroke and transient ischemic attack

Abstract

Background and purpose: Rapid evaluation of stroke risk following an initial stroke may improve patient outcome, especially in cases of minor stroke. We investigated the validity of the Essen stroke risk score (ESRS) and stroke prognosis instrument II (SPI-II) scales for predicting the short-term risk of minor stroke and transient ischemic attack (TIA) in the clinic.

Methods: One hundred and sixty-seven patients with minor stroke or TIA were enrolled in this study. The recurrent ischemic events were recorded within 90 days after the initial onset and the curve of cumulative survival rate was calculated to observe the recurrence risk. The prognostic value of the ESRS and SPI-II scales for recurrence risk were evaluated by calculating the area under receiver operating characteristic (ROC) curve.

Results: The total recurrence rate of ischemic events within 90 days was 12·57% while the recurrence rate was 7·78% in the first week after onset. Remarkable change was observed on the curve of cumulative survival rate during the acute phase of stroke. The area under the ROC curve of the ESRS scale was 0·677 (95% CI: 0·557–0·797) compared to 0·553 (95% CI: 0·413–0·694) of the SPI-II scale.

Conclusion: The ESRS and SPI-II scales can be used as screening tools to evaluate the short-term risk for recurrent events of minor stroke and TIA. Importantly, the ESRS was more suitable for predicting the short-term risk of stroke in the clinic.

Keywords:

• Minor stroke
• Short-term recurrent risk
• ESRS scale
• SPI-II scale