The ABCD² score is a

clinical prediction rule A clinical prediction rule or clinical probability assessment specifies how to use medical signs, symptoms, and other findings to estimate the probability of a specific disease or clinical outcome. Physicians have difficulty in estimated risks of ...

used to determine the risk for

stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...

in the days following a

transient ischemic attack A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same Symptoms of stroke, symptoms associated with strokes, such as weakness or numbn ...

(TIA, a condition in which temporary brain dysfunction results from oxygen shortage in the

brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a v ...

). Its usefulness was questioned in a 2015 review as it was not found to separate those who are at low from those who are at high risk of future problems. A high score correctly predicted 87% of the people who did have a stroke in the following 7 days but also many people who did not have problems. The ABCD² score is based on five parameters (age,

blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...

, clinical features, duration of TIA, and presence of

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

); scores for each item are added together to produce an overall result ranging between zero and seven. People found to have a high score are often sent to a specialist sooner. Other clinical

risk factor In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection. Due to a lack of harmonization across disciplines, determinant, in its more widely accepted scientific meaning, is often use ...

s, such as atrial fibrillation and anticoagulation treatment, as well as ongoing or recurrent TIA, are also relevant. The ABCD² score was proposed in 2007 as a modified version of the ABCD score of 2005 (the ABCD score did not consider the presence of diabetes). In the largest study based on emergency department testing of the ABCD² score in an acute setting, the score performed poorly in both high-risk and low-risk patients. The study found the score to be 31.6% sensitive in high-risk patients (score >5) and only 12.5% specific in low-risk patients (score ≤2).

Scoring system

* For example, a person aged 60 ''(1 point)'' with normal blood pressure ''(0 point)'' and without diabetes ''(0 point)'' who experienced a TIA lasting 10 minutes ''(1 point)'' with a speech disturbance but no weakness on one side of the body ''(1 point)'' would score a ''total of 3 points''.

Interpretation

The risk for stroke can be estimated from the ABCD² score as follows: * Score 1-3 (low) ** 2 day risk = 1.0% ** 7 day risk = 1.2% * Score 4-5 (moderate) ** 2 day risk = 4.1% ** 7 day risk = 5.9% * Score 6–7 (high) ** 2 day risk = 8.1% ** 7 day risk = 11.7%

References

External links

ABCD² score online calculator

ABCD² Score for TIA
with expert insights {{DEFAULTSORT:Abcd2 Score Diagnostic neurology Medical scoring system Stroke