🧠 ABCD² Score (Stroke Risk After TIA)
UseRisk-stratify TIA, though current pathways favour rapid specialist review for all.
Strata0–3 low, 4–5 moderate, 6–7 high short-term stroke risk historically — contemporary pathways still urge rapid …
LimitsLimited discrimination — do not use ABCD² alone to defer urgent evalu… · Combine with ECG, brain and vascular imaging per stroke-service proto… · Same-day specialist pathways supersede outpatient delay based on a lo…
SourceJohnston SC, et al. Lancet 2007
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adults with suspected acute stroke when quantifying deficit and deciding reperfusion, or TIA when judging short-term risk.
- Who it is not for
- Do not use ABCD² to decide thrombolysis. No new stroke scale.
- Formula and variables
- NIHSS is the neurologic deficit; items stay as on this page. FAST-ED is a prehospital large-vessel screen. ABCD² is age, blood pressure, clinical features, duration, and diabetes, for TIA.
- Result → next step
- This score is only short-term risk after TIA. It does not decide thrombolysis and does not open thrombectomy. No fourth stroke score.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.
- Guideline
- China acute ischemic stroke guideline 2023
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Methodology · worked example, guidelines & full notes
Limited discrimination — do not use to defer assessment.
When to use
Risk-stratify TIA, though current pathways favour rapid specialist review for all.
How it works
Age ≥ 60 (1), BP ≥ 140/90 (1), clinical features (weakness 2 / speech 1), duration (≥60 min 2 / 10–59 1), diabetes (1). 0–3 low, 4–5 moderate, 6–7 high.
Key points
- Limited discrimination — do not use to defer assessment.
- Most services urgently evaluate and image all TIAs.
- Combine with imaging (carotid, brain) and ECG.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age ≥ 60 | No |
|---|---|
| BP ≥ 140/90 mmHg | No |
| Clinical features | Speech disturbance, no weakness (1) |
| Duration | 10–59 min (1) |
| Diabetes | No |
→ABCD²2/7
- 2-day stroke risk：Low (~1% 2-day stroke risk)
- Note：Many stroke services now admit/urgently evaluate all TIAs regardless of score.
| Age ≥ 60 | No |
|---|---|
| BP ≥ 140/90 mmHg | No |
| Clinical features | Unilateral weakness (2) |
| Duration | ≥ 60 min (2) |
| Diabetes | No |
→ABCD²4/7
- 2-day stroke risk：Moderate (~4%)
- Note：Many stroke services now admit/urgently evaluate all TIAs regardless of score.
Verification & sources · governance
FAQ
Frequently asked questions
- Does ABCD² Score (Stroke Risk After TIA) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is ABCD² Score (Stroke Risk After TIA) calculated in practice? Can you show a worked example?
- Inputs: Age ≥ 60 No, BP ≥ 140/90 mmHg No, Clinical features Speech disturbance, no weakness (1), Duration 10–59 min (1), Diabetes No → Result: ABCD² 2 /7（2-day stroke risk: Low (~1% 2-day stroke risk), Note: Many stroke services now admit/urgently evaluate all TIAs regardless of score.） Inputs: Age ≥ 60 No, BP ≥ 140/90 mmHg No, Clinical features Unilateral weakness (2), Duration ≥ 60 min (2), Diabetes No → Result: ABCD² 4 /7（2-day stroke risk: Moderate (~4%), Note: Many stroke services now admit/urgently evaluate all TIAs regardless of score.）