ABCD² score after transient ischaemic attack
The ABCD² score estimates the risk of stroke in the first days after a transient ischaemic attack (TIA). It consists of five clinical items.
⚠︎ Learning tool for medical education – not for use in patients or for treatment decisions.
Classification (original publication)
| Score | Classification (original publication) |
|---|---|
| 0–3 | Low risk – 2-day stroke risk about 1% in the Johnston 2007 validation |
| 4–5 | Moderate risk – 2-day stroke risk about 4% in the Johnston 2007 validation |
| 6–7 | High risk – 2-day stroke risk about 8% in the Johnston 2007 validation |
Limitations
Even a low score does not rule out early stroke. In later studies, the ABCD² score discriminated less well between high- and low-risk patients than in the original study (Perry 2011: area under the curve 0.56–0.65; meta-analysis by Wardlaw 2015: a score of 4 or more is sensitive but not very specific); it does not replace imaging or vascular assessment.
FAQ
What does ABCD² stand for?▾
Age, blood pressure, clinical features, duration and diabetes – two Ds, hence the “²”.
References
- Johnston SC et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007;369:283–92. · PubMed
- Perry JJ et al. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. CMAJ 2011;183:1137–45. · PubMed
- Wardlaw JM et al. ABCD2 score and secondary stroke prevention: meta-analysis and effect per 1,000 patients triaged. Neurology 2015;85:373–80. · PubMed
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Open in browser Download on the App StoreIntended purpose: learning tool for medical education only. Not intended for use in patients or for diagnostic or treatment decisions; not a medical device. Calculations follow the cited original publications; no guarantee of completeness or correctness. Last updated: 10/2026 · Dr. Pascal Bafteh