On the Shoulders of Giants
Don’t Be the Next M&M
Aspects of the California and ABCD scores to predict short-term stroke risk after transient ischemic attack (TIA) were studied, and a unified ABCD2 score was derived and subsequently validated. The score has 5 parts. They are below. Even better, use MDCalc!
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Age >/= 60 years = 1 point
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Blood pressure >/= 140/90 mm Hg = 1 point
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Clinical features: unilateral weakness = 2 points
Speech impairment without weakness = 1 point -
Duration >/= 60 min = 2 points
10-59 min = 1 point -
Diabetes = 1 point
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
Spoon Feed
The ABCD2 score is a fair predictor of stroke risk after TIA. Most agree that scores 4 and up need hospitalization, but it’s best to avoid using it to decide which patients to send home.
Source/Another Spoonful
Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet. 2007 Jan 27;369(9558):283-92.
For patients who are going home, recommend an aspirin a day (any dose x 3 months), NNT to prevent 1 stroke at 6 weeks = 72.
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