This is a bit of an interesting idea – a repurposing of the ABCD2 prediction instrument for TIAs as a risk-stratification instrument for cerebrovascular causes of “dizziness.”
Every ED physician loves the complaint of “dizziness.” It’s either giddiness, unsteadiness, lightheadedness, vertigo, and it’s frequently difficult to elicit any pertinent neurologic symptoms to clarify one of the benign causes of vertigo or a cerebrovascular cause.
This is a retrospective chart review in which they evaluated the charts of 907 “dizzy patients”, 37 of which had a cerebrovascular cause – 4.1%. It’s a small sample size – so the confidence intervals for their odds ratios are very wide – but for multivariable adjusted odds, age > 60 had an increased OR of 5.1, BP >140/90 had an increased OR of 2.9, speech disturbance had an OR of 6.2, and unilateral weakness had an OR of 10.9. Essentially, it’s interesting to see – and it makes sense – that the same features that generally portend stroke after TIA also might help predict which of your dizzy patients will be higher yield for a more intensive evaluation.
“Application of the ABCD2 Score to Identify Cerebrovascular Causes of Dizziness in the Emergency Department”
http://www.ncbi.nlm.nih.gov/pubmed/22442167