ABCD2 scoring system
The ABCD2 score is a validated risk assessment tool designed to identify individuals at high early risk of subsequent stroke after a transient ischaemic attack (TIA). Assessing people rapidly can minimise the chances of a full stroke occurring, as there is a 20% risk of a full stroke within the first 4 weeks after a TIA.
1,2 SCORING SYSTEM
Clinical feature Score A – Age (≥60 years) 1 B – Blood pressure at presentation (≥140/90 mmHg) 1 C – Clinical features: unilateral weakness 2 speech disturbance without weakness 1 D – Duration of symptoms: ≥60 minutes 2 10–59 minutes 1 D – Diabetes mellitus 1 Total ABCD2 score 0–7 Interpretation3,4 Early risk of stroke after TIA: 2-day risk of stroke: Scores 0–3: low risk, 1% Scores 4–5: moderate risk, 4.1% Scores 6–7: high risk, 8.1%
● People with a score of ≥4 are regarded as being at a higher risk of early stroke. Aspirin 300 mg daily should be started immediately and specialist assessment (exclusion of stroke mimics, identification of vascular treatment, identification of likely causes) and investigation should happen (in a TIA clinic) within 24 hours of onset of symptoms.
● People with a score of ≤3 are considered at lower risk but should also start aspirin 300 mg daily and have specialist assessment and investigation within a maximum of 7 days of onset of symptoms
The ABCD2 score is a validated risk assessment tool designed to identify individuals at high early risk of subsequent stroke after a transient ischaemic attack (TIA). Assessing people rapidly can minimise the chances of a full stroke occurring, as there is a 20% risk of a full stroke within the first 4 weeks after a TIA.
1,2 SCORING SYSTEM
Clinical feature Score A – Age (≥60 years) 1 B – Blood pressure at presentation (≥140/90 mmHg) 1 C – Clinical features: unilateral weakness 2 speech disturbance without weakness 1 D – Duration of symptoms: ≥60 minutes 2 10–59 minutes 1 D – Diabetes mellitus 1 Total ABCD2 score 0–7 Interpretation3,4 Early risk of stroke after TIA: 2-day risk of stroke: Scores 0–3: low risk, 1% Scores 4–5: moderate risk, 4.1% Scores 6–7: high risk, 8.1%
● People with a score of ≥4 are regarded as being at a higher risk of early stroke. Aspirin 300 mg daily should be started immediately and specialist assessment (exclusion of stroke mimics, identification of vascular treatment, identification of likely causes) and investigation should happen (in a TIA clinic) within 24 hours of onset of symptoms.
● People with a score of ≤3 are considered at lower risk but should also start aspirin 300 mg daily and have specialist assessment and investigation within a maximum of 7 days of onset of symptoms
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