TIA Risk Stratification with the Canadian TIA Score

Dr. Brandon Chang

edited by Ilyas Taraki


Patients who have a transient ischemic attack (TIA) are known to be at high risk of subsequent stroke, especially in the week following the initial event. However, these patients are on a continuum from low to high risk. The ability to risk stratify a group of TIA patients for potential outpatient follow-up could be useful in low-resourced or strained hospital settings. An adequate scoring tool could allow patients to safely access outpatient care while decreasing inpatient admission and resource utilization. The recently validated Canadian TIA score presents an opportunity to do so and this study will evaluate its effectiveness and compare it to previous scoring tools.

Study Design


Canadian TIA Score


Overall, the Canadian TIA score has been validated for clinical use and is a much more useful scoring tool compared to the previous ABCD2/ABCD2i scoring tools. It also answered a clinically important question of identifying a low risk TIA population.

Strengths include a large study population as well as multiple practice settings. However, it is somewhat limited in its complexity (although utilization could be increased with EMR integration) and also regionality (this study was performed in Canada only). Per this study, a small, but not insignificant proportion of patients could be identified for outpatient follow-up.

Although it depends on the practice setting, health care resources, and ability to provide timely outpatient follow-up, this tool could be useful in low-resource environments to provide care for TIA patients


Perry J J, Sivilotti M L A, Emond M, Stiell I G, Stotts G, Lee J et al. Prospective validation of Canadian TIA Score and comparison with ABCD2 and ABCD2i for subsequent stroke risk after transient ischaemic attack: multicentre prospective cohort study BMJ 2021; 372 :n49 doi:10.1136/bmj.n49