Admission is, however, generally recommended for patients with a score ≥ 4 to ensure prompt evaluation and intervention to reduce the risk of subsequent early stroke. Based on the presumed low risk of stroke within the first 2 days after a TIA, hospital admission may be unnecessary for most patients with a score ≤ 3 in the absence of atrial fibrillation (AF). The ABCD 2 score, which considers age, blood pressure, clinical features, duration of symptoms, and history of diabetes, has been shown to predict the short-term stroke risk after TIA and is being used to triage TIA patients. The decision to admit TIA patients based on the ABCD 2 score alone is not supported by our experience and requires further study.īecause population-based studies have shown that the risk of stroke after a transient ischemic attack (TIA) is high, immediate evaluation and treatment is warranted. Patients with an ABCD 2 score ≤ 3 had an equal chance of requiring IHI as those with a score of 4–7. One patient (0.8%) worsened during hospitalization none had a stroke during follow-up. However, among 12 patients (10%) with IHI, ABCD 2 score categories were equally distributed (10% in 0–3, 9% in 4–5, and 10% in 6–7 p = 0.8).
Their percentages increased with higher ABCD 2 scores. Fourteen (12%) had small infarcts on diffusion magnetic resonance imaging 38 (31%) had a new risk factor recognized during admission. We used chi-square for trend to examine the association between ABCD 2 and IHI. We defined IHI as arterial revascularization or anticoagulation required during admission. We determined ABCD 2 upon admission and collected the results of in-hospital evaluation, treatments initiated during hospitalization, and follow-up status. We analyzed prospectively collected data from consecutive TIA patients over 12 months. We thus conducted this study to investigate the relationship between the ABCD 2 score and IHI. The ability of the ABCD 2 score to predict IHI would strengthen the rationale to use it as a decision-making tool. Whether the score can predict the need for in-hospital intervention (IHI), other than initiation of antiplatelets and statins, is unknown. The ABCD 2 score is increasingly being used to triage patients with transient ischemic attack (TIA).