ABCD2 Score

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Table: ABCD2 Score

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TIA Prognosis and Key Mx Considerations by National Stroke Association

ABCD2 Score:

  • Discharge low risk scores (ABCD 0-3)
    • outpatient work-up within 1-2 days (alternate option: admit for work-up)
    • DIAGNOSTICS:
      • carotid imaging (US, CTA, MRA)
      • Consider TTE; if high suspicion for cardioembolic source / bilateral infarcts, obtain TEE
      • Consider 30-d ambulatory cardiac monitor to detect cryptogenic Afib
    • smoking cessation
    • THERAPEUTICS:
      • Start antiplatelet therapy:
        • ASA 81mg/day or
        • Clopidogrel 75mg/day or
        • ASA 25mg/ER dipyridamole 200mg BID
      • start high-intensity statins
        • Atorvastatin 40-80mg/d or
        • Rosuvastatin 20-40mg/day
      • *consider moderate intensity statins if >75y/o
        • Atorvastatin 10-20mg/d or
        • Rosuvastatin 5-10mg/d or
        • Simvastatin 20-40mg/d or
        • Pravastatin 40-80mg/d
      • Consider OAC or LMWH if rhythm shows atrial fibrillation – calculate CHADSVASC and HAS BLED score to guide therapy

    Admit high risk TIAs (ABCD2 scores >3)

    • Admit to hospital
    • Permissive hypertension (up to 220/120mm Hg) and gradually lower over 24-48h

Reference:

Stroke.org. (2017). [online] Available at: http://www.stroke.org/sites/default/files/resources/tia-abcd2-tool.pdf?docID [Accessed 31 Jul. 2017].

Gross, Hartmut, and Noah Grose. 2017. “Emergency Neurological Life Support: Acute Ischemic Stroke”. Neurocritical Care 27 (S1): 102-115. doi:10.1007/s12028-017-0449-9.

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