The ABCD 2 score is increasingly being used to triage patients with transient ischemic attack (TIA). Whether the score can predict the need for in-hospital intervention (IHI), other than initiation of antiplatelets and statins, is unknown.
The ability of the ABCD 2 score to predict IHI would strengthen the rationale to use it as a decision-making tool. We thus conducted this study to investigate the relationship between the ABCD 2 score and IHI.
We analyzed prospectively collected data from consecutive TIA patients over 12 months. We determined ABCD 2 upon admission and collected the results of in-hospital evaluation, treatments initiated during hospitalization, and follow-up status. We defined IHI as arterial revascularization or anticoagulation required during admission. We used chi-square for trend to examine the association between ABCD 2 and IHI.
We studied 121 patients. Fourteen (12%) had small infarcts on diffusion magnetic resonance imaging; 38 (31%) had a new risk factor recognized during admission [hyperlipidemia ( n = 9), hypertension (1), diabetes (1), carotid stenosis ≥ 50% (16), other arterial occlusive lesions (7), and potential cardioembolic source (4)]. Their percentages increased with higher ABCD 2 scores. 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). One patient (0.8%) worsened during hospitalization; none had a stroke during follow-up.