ABCD² Score
Neurology
Early stroke risk after a transient ischaemic attack, at two, seven and ninety days.
How it is calculated
- Age 60 or over scores 1.
- Blood pressure of 140/90 mmHg or more at first assessment scores 1.
- Clinical features score 2 for unilateral weakness, or 1 for speech disturbance without weakness.
- Duration scores 2 for 60 minutes or more, or 1 for 10 to 59 minutes.
- Diabetes scores 1. The maximum is 7.
- Pooled across six validation cohorts and 4,799 patients, two-day stroke risk was 1.0 per cent at 0–3, 4.1 per cent at 4–5 and 8.1 per cent at 6–7.
- The score stratifies a population; it does not identify which individual will have a stroke. Current guidelines favour urgent specialist assessment and imaging for everyone with a suspected TIA rather than triage by score alone.
References
- Johnston SC, Rothwell PM, Nguyen-Huynh MN, Giles MF, Elkins JS, Bernstein AL, Sidney S. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007;369:283-292.
About these tools
OcuLearning Clinical Tools is part of an educational platform. These calculators are provided for learning and reference, and are not medical advice, a diagnosis, or a treatment recommendation.