ABCD predicts stroke risk after ‘mini-stroke’
A scoring system based on a patient’s age, blood pressure, clinical features and duration of symptoms - the ABCD score - can be used to estimate the risk of a full-blown stroke in the 7 days after a TIA or ‘mini-stroke’, British investigators report.
Apart from identifying patients who should get emergency care, the risk score will also be useful for raising people’s awareness of the symptoms of stroke, Dr. Peter M. Rothwell, from the University of Oxford, and his colleagues note in their report in The Lancet medical journal.
Rothwell’s team studied a population-based group of 209 patients with TIA, among whom 18 suffered strokes within 7 days.
The researchers investigation generated a 6-point score based on age (60 years or older = 1 point), blood pressure (greater than 140/90 mm Hg = 1), clinical features of TIA (one-sided weakness = 2, speech disturbance without weakness = 1, other = 0), and duration (60 minutes or longer = 2, 10 to 59 minutes = 1, less than 10 = 0).
The team validated the risk score in a second population-based group of 375 people with TIA. Nineteen of the 20 strokes that occurred within 7 days in this group occurred in patients with a risk score of 5 or 6.
“An ABCD score of 6 necessitates not only emergency investigation and treatment but also admission to hospital during the acute phase,” Rothwell and colleagues advise. Even if a stroke can’t be prevented, they point out, being in the hospital should allow for immediate clot-clearing treatment if one occurs.
SOURCE: Lancet, online June 21, 2005.
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