Multicenter external validation of the ABCD super(2) score in triaging TIA patients

Objectives: A simple clinical score (ABCD super(2) score) has been introduced to triage TIA patients with a high early risk of stroke. External validation studies have yielded inconsistent results regarding the predictive ability of the ABCD super(2) score. We aimed to prospectively validate the former score in a multicenter case series study. Methods: We prospectively calculated the ABCD super(2) score (age [.60 years: 1 point]; blood pressure [systolic >140 mm Hg or diastolic >90 mm Hg: 1 [; clinical features [unilateral weakness: 2, speech disturbance without weakness: 1, other symptom: 0]; duration of symptoms [3 points (28%, 95% CI 18%-38%) than in patients with an ABCD super(2) score ,3 points (4%, 95% CI 0%-9%). After adjustment for stroke risk factors, race, history of previous TIA, medication use before the index TIA and secondary prevention treatment strategies, an ABCD super(2) score of >2 was associated with a nearly 5-fold greater 90-day risk of stroke (hazard ratio 4.65, 95% CI 1.04-20.84, p = 0.045). Conclusion: Our findings externally validate the usefulness of the ABCD super(2) score in traging TIA patients with a high risk of early stroke in a multiethnic sample of hospitalized patients. The present data support current guidelines endorsing the immediate hospitalization of patients with an ABCD super(2) score >2.