Application of the ABCD 2 Score to Identify Cerebrovascular Causes of Dizziness in the Emergency Department

• DOI: 10.1161/strokeaha.111.646414
• Publication Date: 2012-03-23T16:28:12Z
• Authors: Babak B. Navi; Hooman Kamel; Maulik P. Shah; Aaron W. Grossman; Christine Wong; Sharon N. Poisson; William D. Whetstone; S. Andrew Josephson; S. Claiborne John...; Anthony S. Kim
• Keywords: Interquartile range; Stroke; Medical record

Background and Purpose— Dizziness can herald a cerebrovascular event. The ABCD 2 score predicts the risk of stroke after transient ischemic attack partly by distinguishing from mimics. We evaluated whether this would also identify events among emergency department patients with dizziness. Methods— retrospectively identified consecutive adults presenting to university primary symptom dizziness, vertigo, or imbalance. Two neurologists independently reviewed medical records determine was caused event (ischemic stroke, attack, intracranial hemorrhage). scores were then assigned using clinical information record. ability discriminate between those other diagnoses quantified c statistic. Results— Among 907 dizzy (mean age, 59 years; 58% female), 37 (4.1%) had cause, majority which strokes (n=24). median 3 (interquartile range, 3–4). predicted ultimate diagnosis (c statistic, 0.79; 95% CI, 0.73–0.85). Only 5 512 (1.0%) ≤3 compared 25 369 (6.8%) 4 7 26 (27.0%) 6 7. Conclusions— may provide useful on at low-risk for having aid frontline providers in acute management if validated prospectively.