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- The ABCD and ABCD2 scores are validated scales based on both prospective and retrospective data to assess patients' risk of stroke at 7 and 2 days after a TIA, respectively. The biggest difference between the two is that the ABCD2 Scale includes diabetes as a factor.
- ABCD Scale
- Age: at least 60 = 1 point
- BP: SBP > 140 and/or DBP > 90 = 1 point
- Clinical features: unilateral weakness = 2 points; speech disturbance w/o weakness = 1 point; any other neurologic finding = 0 points.
- Duration: at least 60 min. = 2 points; 10-59 min. = 1 point; < 10 min. = 0 points.
- Score: 4 points = 1.1% risk; 5 points = 12.1% risk; 6 points = 31.4% risk.
- ABCD2 Scale
- Age: same as ABCD Scale
- BP: same as ABCD Scale
- Clinical features: same as ABCD Scale except "any other neurologic finding = 0 points" component is omitted.
- Duration: same as ABCD Scale except "< 10 min. = 0 points" component is omitted.
- Diabetes: 1 point
- Score: 4-5 points = 4% risk; 6-7 points = 8% risk; 0-3 points = 1% risk.
- Question = When considering sending a patient home prior to a thorough and appropriate TIA/stroke work-up, how low of a percent risk is acceptable?
References
- Lancet 2005; 366: 29-36.
- Lancet 2007; 369: 283-92.
- ACEP News, June 2008.