ABCD² Score for TIA

Estimates the risk of stroke after a suspected transient ischemic attack (TIA).

precautions

he ABCD2 score was developed to help physicians risk stratify patients presenting with a TIA for how likely they are to suffer a subsequent stroke.

The largest prospective study of using the ABCD2 score in the emergency department found that the score performed poorly (low sensitivity for identifying low risk patients, low specificity for identifying high risk patients).

Multiple studies have shown that as the ABCD2 score increases the risk of a subsequent stroke also increases.

Patients with a low baseline risk of stroke (≤ 2%) with a low ABCD2 score (0-2) are at low risk for having a stroke within the next 7 days (0.4-0.8%).

Points to keep in mind:

The ABCD2 score was developed in the outpatient (non-emergency department) setting.

It has been shown to have lower accuracy when used by non-specialists (primary care or emergency physicians).

The ABCD2 has less impact on risk stratification when applied in settings where the patients were at low baseline risk of stroke.

items

• Age ≥ 60 years
• BP ≥ 140/90 mmHg : Initial BP. Either SBP ≥ 140 or DBP ≥ 90.
• Clinical features of the TIA
  • Unilateral weakness+2
  • Speech disturbance without weakness+1
  • Other symptoms0

• Duration of symptoms
  • <10 minutes0
  • 10-59 minutes+1
  • ≥ 60 minutes+2
• History of diabetes

0 points

Per the validation study, 0-3 points: Low Risk

• 2-Day Stroke Risk: 1.0%
• 7-Day Stroke Risk: 1.2%
• 90-Day Stroke Risk: 3.1%

reference

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