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(Stroke. 2006;37:1636.)
© 2006 American Heart Association, Inc.

Editorials

Is the ABCD Score Truly Useful?

Michael D. Hill, MD, MSc Nicolas U. Weir, MD, MSc

From the University of Calgary, Department of Clinical Neuroscience, Foothills Medical Centre, Calgary, AL, Canada.

Correspondence to Michael D. Hill, MD, University of Calgary, Department of Clinical Neuroscience, Rm 1242A, Foothills Medical Centre, 1403 29th Street NW, Calgary, Al T2N 2T9, Canada. E-mail michael.hill@calgaryhealthregion.ca

Key Words: acute stroke • transient ischemic attack

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The understanding of transient ischemic attack (TIA) has changed. The high early risk of stroke demands rapid assessment and treatment. Some patients, such as those with TIA attributable to an active carotid artery plaque, appear to be at higher risk than others.¹ The direct result of this paradigm shift is the need to develop tools for stratifying patients according to risk. Although some have adopted a strategy of admitting all TIA patients, this approach may not be the most efficient. Clinical prediction rules may be the most helpful in triaging patients. Factors that are risks for early stroke include clinical ones such as age, diabetes mellitus, longer duration TIA, motor or speech symptoms of TIA, and imaging factors such as the presence of carotid artery disease or a diffusion-weighted imaging lesion on MRI.^2–4 The clinical imperative is to sort out those patients who need immediate attention and those who do not.

Why must we risk stratify? A large number of TIA patients do not go on to experience an early stroke. These patients do not need to be exposed to potentially risky therapies from which they will derive no benefit, nor do they need to use scarce and high-intensity resources. The corollary is that we need to learn how to identify those patients who truly are at high risk and offer them emergent assessment, imaging and therapies where the benefit clearly outweighs the risk.

The ABCD score, developed in England, is a clinical tool to stratify TIA patients according to . . . [Full Text of this Article]

Related Article:

Is the ABCD Score Useful for Risk Stratification of Patients With Acute Transient Ischemic Attack?

Brett L. Cucchiara, Steve R. Messe, Robert A. Taylor, James Pacelli, Douglas Maus, Qaisar Shah, and Scott E. Kasner
Stroke 2006 37: 1710-1714. [Abstract] [Full Text] [PDF]

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				T. J. Quinn, A. C. Cameron, J. Dawson, K. R. Lees, and M. R. Walters ABCD2 Scores and Prediction of Noncerebrovascular Diagnoses in an Outpatient Population: A Case-Control Study Stroke, March 1, 2009; 40(3): 749 - 753. [Abstract] [Full Text] [PDF]