ABCD2 score

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The ABCD2-Score (also ABCD²-Score) is a medical scoring system that can be used to assess the risk of strokes after transient ischemic attacks (TIA). In the score flow five independent risk factors - A lter, B lutdruck, C linical features (symptoms), D except the symptoms and D iabetes mellitus - one for each provider according to certain criteria points (see table). The points awarded are added together so that a score between 0 and 7 points results. The ABCD2 score emerged from two older scoring systems, the ABCD score and the California score , and includes criteria for both scores.

Score

ABCD2 score
Risk factor criteria Points
A = age <60 years
≥ 60 years 		0
1
B = blood pressure <140 syst. And <90 diast. mm Hg
> 140 syst. or> 90 diast. mmHg 		0
1
C = Clinical features (symptoms) other complaints
speech disorder without unilateral weakness
unilateral weakness 		0
1
2
D = duration of symptoms <10 min
10-59 min
≥ 60 min 		0
1
2
D = diabetes mellitus not existing
existing 		0
1

Risk assessment

The ABCD2 score was developed using four cohorts in California and Oxford with a total of 4908 TIA patients. The risk of developing another stroke within two days of a TIA was determined as follows:

  • 6 to 7 points: high two-day risk (8%)
  • 4 to 5 points: Moderate two-day risk (4%)
  • 0 to 3 points: Low two-day risk (1%)

According to the guidelines of the American Heart Association and the American Stroke Association , it makes sense to admit patients with TIA as inpatients for further diagnosis and therapy who present within 72 hours of the onset of symptoms and who have an ABCD2 score of ≥ 3. Inpatient admission is also useful if there is an ABCD2 score of 0 to 2 and there are doubts as to whether the stroke diagnosis can be carried out within two days or if there are other indications of a focal circulatory disorder.

The predictive value of the ABCD2 score has been examined in numerous studies. The test results were inconsistent and ranged from high to very low predictive values.

literature

Review articles

Individual evidence

  1. ↑ a b J. D. Easton, JL Saver et al. a .: Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association / American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. In: Stroke; a journal of cerebral circulation Volume 40, Number 6, June 2009, pp. 2276-2293, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.108.192218 . PMID 19423857 . (Review).
  2. ↑ Translated and modified from SC Johnston, PM Rothwell u. a .: Validation and refinement of scores to predict very early stroke risk after transient ischemic attack. In: Lancet Volume 369, Number 9558, January 2007, pp. 283-292, ISSN  1474-547X . doi : 10.1016 / S0140-6736 (07) 60150-0 . PMID 17258668 .
  3. ↑ a b J P. Kistler et al .: Initial evaluation and management of transient ischemic attack and minor stroke. In: UpToDate, Version 19.2, May 2011. Full text (fee required )
  4. ↑ JJ Perry, M. Sharma et al. a .: Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. In: Canadian Medical Association Journal. Volume 183, Number 10, July 2011, pp. 1137-1145, ISSN  1488-2329 . doi : 10.1503 / cmaj.101668 . PMID 21646462 .
  5. ↑ G. Tsivgoulis, I. Heliopoulos: potential and failure of the ABCD2 score in stroke risk prediction after transient ischemic attack. In: Stroke Volume 41, Number 5, May 2010, pp. 836-838, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.110.579169 . PMID 20299665 .
  6. ↑ G. Tsivgoulis, E. Stamboulis and a .: Multicenter external validation of the ABCD2 score in triaging TIA patients. In: Neurology Volume 74, Number 17, April 2010, pp. 1351-1357, ISSN  1526-632X . doi : 10.1212 / WNL.0b013e3181dad63e . PMID 20421579 .
  7. ↑ OC Sheehan, L. Kyne et al. a .: Population-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study. In: Stroke; a journal of cerebral circulation Volume 41, number 5, May 2010, pp. 844-850, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.109.571844 . PMID 20299667 .
  8. ↑ A. Chandratheva, OC Geraghty et al. a .: ABCD2 score predicts severity rather than risk of early recurrent events after transient ischemic attack. In: Stroke; a journal of cerebral circulation Volume 41, number 5, May 2010, pp. 851-856, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.109.570010 . PMID 20299668 .
  9. ↑ H. Ay, EM Arsava et al. a .: Clinical- and imaging-based prediction of stroke risk after transient ischemic attack: the CIP model. In: Stroke; a journal of cerebral circulation Volume 40, Number 1, January 2009, pp. 181-186, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.108.521476 . PMID 18948609 .
  10. ↑ D. Calvet, E. Touzé et al. a .: DWI lesions and TIA etiology improve the prediction of stroke after TIA. In: Stroke; a journal of cerebral circulation Volume 40, Number 1, January 2009, pp. 187-192, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.108.515817 . PMID 18988917 .
  11. ^ A. Fothergill, TJ Christianson et al. a .: Validation and refinement of the ABCD2 score: a population-based analysis. In: Stroke; a journal of cerebral circulation Volume 40, number 8, August 2009, pp. 2669-2673, ISSN  1524-4628 . doi : 10.1161 / STROKEAHA.109.553446 . PMID 19520983 . PMC 275385 (free full text).

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