Predictive value of the Essen Stroke Risk Score and Ankle Brachial Index in acute ischaemic stroke patients from 85 German stroke units.
BACKGROUND
Risk stratification can contribute to individualised optimal secondary prevention in patients with cerebrovascular disease.


OBJECTIVE
To prospectively investigate the prediction of the Essen Stroke Risk Score (ESRS) and a pathological Ankle Brachial Index (ABI) in consecutive patients hospitalised with acute ischaemic stroke or transient ischaemic attack (TIA) in 85 neurological stroke units throughout Germany.


METHODS
852 patients were prospectively documented on standardised case report forms, including assessment of ESRS and ABI. After 17.5 months, recurrent cerebrovascular events, functional outcome or death could be assessed in 729 patients predominantly via central telephone interview.


RESULTS
After discharge from the documenting hospital, recurrent stroke occurred in 41 patients (5.6%) and recurrent TIA in 15 patients (2.1%). 52 patients (7.1%) had died, 33 (4.5%) from cardiovascular causes. Patients with an ESRS > or = 3 (vs <3) had a significantly higher risk of recurrent stroke or cardiovascular death (9.7% vs 5.1%; odds ratio (OR) 2.00, 95% confidence interval (CI) 1.08 to 3.70) and a higher recurrent stroke risk (6.9% vs 3.7%; OR 1.93, 95% CI 0.95 to 3.94). Patients with an ABI < or = 0.9 (vs > 0.9) had a significantly higher risk of recurrent stroke or cardiovascular death (10.4% vs 5.5%; OR 2.00, 95% CI 1.12 to 3.56) and a higher recurrent stroke risk (6.6% vs 4.6%; OR 1.47, 95% CI 0.76 to 2.83).


CONCLUSIONS
Our prospective follow-up study shows a significantly higher rate of recurrent stroke or cardiovascular death and a clear trend for a higher rate of recurrent stroke in patients with acute cerebrovascular events classified as high risk by an ESRS > or = 3 or a pathological ABI.
Weimar
C
C
Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, D- 45122 Essen, Germany. stroke.med@uni-essen.de
Goertler
M
M
Röther
J
J
Ringelstein
E B
EB
Darius
H
H
Nabavi
D G
DG
Kim
In-Ha
IH
Benemann
Jens
J
Diener
Hans-Christoph
HC
D000368:Aged; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000378:metabolism; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000473:pathology; D005500:Follow-Up Studies; D005858:Germany; D006761:Hospitals; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000473:pathology; D016896:Treatment Outcome