Page 1 of 1: ABCD Score

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A simple score (ABCD) to identify individuals at high early
risk of stroke after transient ischaemic attack -lancet 2005

Analysis of predefined risk factors in the derivation cohort found that age >60 years, clinical features, symptom duration, and elevated blood pressure (BP) at presentation were predictive of stroke (P >0.1) and diabetes and previous diagnosis of HTN were not.

The resulting risk score, termed the ABCD score,
Age ( 60 y = 1),
BP (> 140 mm Hg systolic or 90 mm Hg diastolic = 1),
Clinical features (unilateral weakness = 2, speech disturbance without weakness = 1, other = 0),
Duration of symptoms (60 min = 2, 10 - 59 min =1, <10 min = 0).

In the hospital-referred clinic cohort, (7·5%) patients had a stroke before their scheduled appointment, all with a score of 4 or greater.

95% stroke-score more than 5
7-day risk was 0·4% - patients with a score less than 5,
12·1 % with a score of 5, and
31·4% with a score of 6.

Conclusions Risk of stroke during the 7 days after TIA seems to be highly predictable. Although further validations and refinements are needed, the ABCD score can be used in routine clinical practice to identify high-risk individuals
who need emergency investigation and treatment.

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