Information:

The ABCD2 stroke score is predictive of which patients are likely to have a stroke within 2 days following a TIA. This score may have implications for which patients might benefit most from hospitalization and more rapid evaluation of the underlying reversible conditions.

In the USA, approximately 240,000 TIAs are diagnosed yearly. Depending upon the sample, 4-20% of patients diagnosed with TIA will have a stroke within 90 days; half of such cases of stroke occur within the first 2 days.

Identification of those at highest and lowest risk of stroke may allow more appropriate use of resources, such as secondary prevention strategies and hospital admission.

The authors note that current guidelines for hospital admission following TIA are vague and depending upon the institution, almost all TIA patients or almost no TIA patients are admitted.

The authors suggest that an ABCD2 score of >=4 might justify admission and inpatient evaluation.

ABCD2 Stroke Score:

The points are added together to get the final score

Factor:

Age >=60 yrs

Score: 1 point

BP >=140/90 mmHg

Score: 1 point

Unilateral weakness

Score: 2 points

Speech impairment without weakness

Score: 1 point

Duration >=60 min

Score: 2 points

Duration 10 to <=59 min

Score: 1 point

Diabetes

Score: 1 point

Results:

High risk: Score 6-7 (8.1% 2 day stroke risk)

Moderate risk: Score 4-5 (4.1% 2 day stroke risk)

Low risk: Score 0-3 (1.0% 2 day stroke risk)

Reference:

Johnston C et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007;369:283-292.