title: The Essen Stroke Risk Score in one-year follow-up acute ischemic stroke patients.
abstract: OBJECTIVE
  We aimed to validate the usefulness of the Essen Stroke Risk Score (ESRS) to predict stroke recurrence in a hospital-based follow-up study.
  
  
  METHODS
  We followed up 730 consecutive patients admitted to a neurological stroke unit in Berlin, Germany, with ischemic stroke (IS) or transient ischemic attack (TIA). The mean follow-up time was 13.4 months (SD 5.9). We calculated the time of event-free survival by Kaplan-Meier estimates.
  
  
  RESULTS
  The cumulative rate of a recurrent stroke was 10.4% (76 of 730). The risk of a recurrent stroke was significantly higher in patients with an ESRS >2 (p = 0.01; log rank). The area under the curve (AUC) was 0.59. The risk of a vascular event (VE), defined as a fatal or nonfatal IS or myocardial infarction, was significantly higher in patients with an ESRS >2 (p = 0.003; log rank). The AUC was 0.58. Stratifying the data at exact 1-year follow-up, 9 of 185 (10.3%) patients with an ESRS ≤2 suffered a recurrent stroke, while 56 of 311 (18%) patients with an ESRS >2 did so (p < 0.02; χ(2)). Thirty-six of 196 (18.4%) patients with an ESRS ≤2 suffered a VE, while 156 of 353 (35.7%) patients with an ESRS >2 did so (p < 0.001; χ(2)).
  
  
  CONCLUSIONS
  The ESRS identifies groups of patients with TIA or IS who are at significantly increased risk for a recurrent stroke and cardiovascular event. Patients with a high ESRS require short-term follow-up and reevaluation of secondary prevention strategies.
authors.affiliation: Department of Neurology, DRK-Kliniken Berlin-Köpenick, Berlin, Germany. sfitzek@googlemail.com
authors.forename: Sabine
authors.initials: S
authors.lastname: Fitzek
authors.forename: Lutz
authors.initials: L
authors.lastname: Leistritz
authors.forename: Otto W
authors.initials: OW
authors.lastname: Witte
authors.forename: Peter U
authors.initials: PU
authors.lastname: Heuschmann
authors.forename: Clemens
authors.initials: C
authors.lastname: Fitzek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006784:Hospitals, Teaching; D006801:Humans; D057187:Independent Living; D002546:Ischemic Attack, Transient / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D013997:Time Factors