Daily Bolus of LR: ABCD2 Score

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June 1, 2011 by dailybolusoflr

ABCD2 Score

This score is a clinical score calculated in patients with suspected TIA to determine the risk for imminent (up to 90 day) stroke.
This score has been debated in the literature and had had multiple validation studies which offer conflicting results. The most recent, published in Neurology in 2010 looked at hospitalized patients seen by neurologists and found a correlation with higher ABCD2 scores and predictive risk of stroke. The advocate use of a ABCD2 score of greater than 2 to determine which patients should be immediately hospitalized for further testing. This does not mean that patients with scores under 2 should be ignored, just that there is agreement these patients need less urgent (within the week) follow up for further testing.

The ABCD2 score is as follows:

Age > or = 60 Yes 1 point
BP > or = 140/90 Yes 1 point
Clinical features Unilateral weakness 2 points
Speech disturbance (no weakness) 1 point
Duration 10-59 minutes 1 point
> 60 minutes 2 points
Diabetes history Yes 1 point

Stroke. 2008 Nov;39(11):3096-8. Epub 2008 Aug 7<http://www.ncbi.nlm.nih.gov/pubmed/20421579> ( this study suggests the reason that higher ABCD2 scores are predictive of higher stroke rates is due to the fact that the ABCD2 score helps ED physicians more accurately diagnose patients with true TIAs)

Neurology 2010 Apr 27;74(17):1351-7.

Linda Regan, MD FACEP
Program Director, Emergency Medicine Residency
Johns Hopkins Medical Institutions

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