The ABCD and ABCD2 Scores and the Risk of Stroke following a TIA: A Narrative Review
نویسندگان
چکیده
The California, ABCD, and ABCD2 risk scores (ABCD system) were developed to help stratify short-term stroke risk in patients with TIA (transient ischemic attack). Beyond this scope, the ABCD system has been extensively used to study other prognostic information such as DWI (diffusion-weighted imaging) abnormalities, large artery stenosis, atrial fibrillation and its diagnostic accuracy in TIA patients, which are independent predictors of subsequent stroke in TIA patients. Our comprehensive paper suggested that all scores have and equivalent prognostic value in predicting short-term risk of stroke; however, the ABCD2 score is being predominantly used at most centers. The majority of studies have shown that more than half of the strokes in the first 90 days, occur in the first 7 days. The majority of patients studied were predominantly classified to have a higher ABCD/ABCD2 > 3 scores and were particularly at a higher short-term risk of stroke or TIA and other vascular events. However, patients with low risk ABCD2 score < 4 may have high-risk prognostic indicators, such as diffusion weighted imaging (DWI) abnormalities, large artery atherosclerosis (LAA), and atrial fibrillation (AF). The prognostic value of these scores improved if used in conjunction with clinical information, vascular imaging data, and brain imaging data. Before more data become available, the diagnostic value of these scores, its applicability in triaging patients, and its use in evaluating long-term prognosis are rather secondary; thus, indicating that the primary significance of these scores is for short-term prognostic purposes.
منابع مشابه
The California, ABCD, and unified ABCD2 risk scores and the presence of acute ischemic lesions on diffusion-weighted imaging in TIA patients.
BACKGROUND AND PURPOSE Some clinical models, like California ABCD and unified ABCD2 scores, are now available to predict the early risk of stroke after a TIA. Despite the transitivity of symptoms, DWI identified an area of acute brain ischemia in almost half of patients. It would be interesting to know how the presence of DWI abnormalities relates to clinical risk scores to plan other prognosti...
متن کاملHigher ABCD2 score predicts patients most likely to have true transient ischemic attack.
BACKGROUND AND PURPOSE Some patients diagnosed with transient ischemic attack (TIA) in the emergency department may actually have alternative diagnoses such as seizure, migraine, or other nonvascular spells. The ABCD2 score has been shown to predict subsequent risk of stroke in patients with TIA diagnosed by emergency physicians, but perhaps high ABCD2 scores simply separate those patients with...
متن کاملThe ABCD, California, and unified ABCD2 risk scores predicted stroke within 2, 7, and 90 days after TIA.
متن کامل
A Comparative Study of hs-CRP Diagnostic Value and ABCD2 Criteria in Predicting the Future Incidence of Acute Cerebrovascular Events during Follow-up in TIA Patients
Background and purpose: Stroke is the most common and the most deadly neurological disease that is accompanied with many complications. The aim of this study was to compare the diagnostic value of hs-CRP and ABCD2 criteria in predicting the future incidence of acute cerebrovascular events during follow-up in patients with transient ischemic attack (TIA). Materials and methods: This cohort stud...
متن کاملComparison of ABCD2 scoring between first healthcare-contact and stroke-specialist physicians for transient ischaemic attack in a rapid-access clinic.
SIR—The ABCD2 stroke risk scoring system based on clinical features found to be independently predictive of stroke following TIA is now in widespread use [1–4]. The Department of Health for England (DoH) aims for 60% of patients with ABCD2 scores of ≥4 at presentation to complete specialist assessment within 24 h of first healthcare-contact and those scoring <4 within 7 days [5]. A systematic r...
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ورودعنوان ژورنال:
دوره 2011 شماره
صفحات -
تاریخ انتشار 2011