Brief Reports: Use of the ABCD2 Score Helps Predict True Ischemic Stroke in Dizzy Patients
Use of the ABCD2 Score Helps Predict True Ischemic Stroke in Dizzy Patients
By Matthew E. Fink, MD
Interim Chair and Neurologist-in-Chief, Department of Neurology and Neuroscience, Weill Cornell Medical College, New York, NY
Dr. Fink is a retained consultant for MAQUET. This article originally appeared in the July issue of Neurology Alert.
Source: Navi BB, et al. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. Stroke 2012;43:1484-1489.
THE ABCD2 SCORE REFERS TO A NUMERICAL SCALE, 0 TO 7, based on a series of clinical features (age > 60, blood pressure > 140/90, clinical features such as weakness or speech disturbance, duration of symptoms > 10 minutes, presence of diabetes) that predicts with a high degree of validity a true ischemic TIA/stroke and helps to distinguish this from other disorders that may mimic a stroke (Lancet 2007;369:283-292). The authors reviewed the charts of 907 dizzy patients who presented to the emergency department at UCSF. Thirty-seven (4.1%) had a cerebrovascular cause, of which 24 were ischemic strokes. The median ABCD2 score was 3, and the score predicted the ultimate diagnosis of a cerebrovascular event (c statistic, 0.79; 95% confidence interval, 0.73-0.85). Only 5 of 512 patients (1%) with a score of ≤ 3 had a cerebrovascular event, compared to 25 of 369 patients (6.8%) with a score of 4 or 5, and 7 of 26 patients (27%) who had a score of 6 or 7. Use of this score in the emergency department may help to stratify low-risk vs high-risk patients and result in more rational and efficient use of scarce resources.Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department.
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