About the ABCD2 Score

Efforts to identify patients who at risk of stroke/TIA can reduce the missed opportunities to offer an effective assessment and prevention. In practice, three prognostic scores have been in use for this purpose: the ABCD score (predict risk of stroke at 7 days), the California score (predict risk of stroke at 90 days) and the more recent ABCD2 score (generated in the two original deviation cohorts by multivariate logistic regression analysis of individual risk factors in both the ABCD and California scores).

The ABCD and California scores had been externally validated (i.e. generalisable) for predicting stroke risk at 2, 7 and 90 days in independent cohorts of patients with TIA. To date, the ABCD2 has been shown to have somewhat greater predictive value and to be the most externally valid prediction tool currently available in practice.

The unified ABCD2 score (range: 0-7) is a summation of 5 independent risk predictors:

A. Age

B. Blood Pressure

C. Clinical Features

D1. Duration of symptoms

D2. Diabetes mellitus

The ABCD2 score can be used in routine clinical practice to triage high-risk individuals who need emergency investigation and treatment into low, moderate and high risk groups. Patients classified as high risk should be prioritised for immediate evaluation, targeted intervention, or even inpatient observation to minimise their risk of future stroke.

Table: A summary guide to the total ABCD2 score