ABCD2

ABCD2 is a clinical prediction rule used in the field of medicine and more specifically in neurology. It is an essential tool for predicting the risk of stroke following a transient ischemic attack (TIA). The ABCD2 score is calculated based on five parameters: Age, Blood pressure, Clinical features, Duration of TIA, and Diabetes.

Overview

The ABCD2 score was developed to improve the prediction of short-term stroke risk after a transient ischemic attack. The score is a simple, easy-to-use and validated tool that uses five clinical features that are each scored to give a total score out of 7.

Scoring

The ABCD2 score is calculated as follows:

• Age: 1 point is given if the patient is aged 60 years or older.
• Blood pressure: 1 point is given if the patient's blood pressure is 140/90 mmHg or higher at presentation.
• Clinical features: 2 points are given for unilateral weakness, 1 point for speech disturbance without weakness.
• Duration of TIA: 2 points are given if the TIA lasted for 60 minutes or more, 1 point if it lasted for 10-59 minutes.
• Diabetes: 1 point is given if the patient has diabetes.

Interpretation

The total ABCD2 score predicts the risk of stroke as follows:

• 0-3 points: low risk
• 4-5 points: moderate risk
• 6-7 points: high risk

This risk stratification can help guide clinical management. For example, patients with a high score may benefit from urgent evaluation and intervention, while those with a low score may be safely managed in an outpatient setting.

Limitations

While the ABCD2 score is a useful tool, it is not perfect. It does not take into account other important risk factors for stroke, such as atrial fibrillation or other cardiac sources of emboli. Therefore, it should be used as part of a comprehensive clinical assessment, not as a standalone tool.