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Validation and Refinement of Scores to Predict Very Early Stroke Risk after TIA

When encountering patients with TIA, how do you decide to admit or not admit?  The reason for admission should include those patients at high risk for stroke. So how do you risk stratify TIA patients?

The ABCD2 score is a simple tool to help clinicians evaluate the risk of subsequent stroke.

  • Age ≥60 years (1 point)
  • Blood pressure elevation: systolic ≥140 mmHg or diastolic ≥90 mmHg after TIA (1 point)
  • Clinical features: unilateral weakness (2 points); isolated speech disturbance (1 point); other (0 points)
  • Duration of TIA symptoms: ≥60 minutes (2 points); 10 to 59 minutes (1 point); <10 minutes (0 points)
  • Diabetes (1 point)

Stroke Risk:

  • Score 6 to 7: High two-day stroke risk (8 percent)
  • Score 4 to 5: Moderate two-day stroke risk (4 percent)
  • Score 0 to 3: Low two-day stroke risk (1 percent)

This article presents the validation study for this risk stratification tool.

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