Medical Scores – A

Medical Scores – A

ABCD2 SCORE FOR RISK OF STROKE AFTER TIA:

• The ABCD2 score is calculated as follows

• Higher ABCD2 scores are associated with a greater risk of stroke during the 2, 7, 30, and 90 days after TIA

ANTITHROMBOTIC THERAPY FOR STROKE PREVENTION IN ATRIAL FIBRILLATION (CHADS2 SCORE):

• CHADS2 score to estimate stroke risk in patients with atrial fibrillation

• Atrial Fibrillation May be associated with thromboembolic events (stroke risk can be assessed by CHADS2 score in nonvalvular AFib; CHADS2-VASc if the former gives a score of 0 or 1)

A VALIDATED CLINICAL AND BIOCHEMICAL SCORE FOR THE DIAGNOSIS OF ACUTE HEART FAILURE:

• The Pro-BNP Investigation of Dyspnea in the Emergency Department (PRIDE) Acute Heart Failure Score.

• Brain natriuretic peptide (BNP):
  • secreted by ventricles due to LV stretch and wall tension.
  • Cardiomyocytes secrete BNP precursor that is cleaved into proBNP. After secretion into ventricles, proBNP is cleaved into the active C-terminal portion and the inactive NT-proBNP.
  • The above scoring algorithm developed by Baggish et al. is commonly used.
  • A score of <6 has a negative predictive value of 98%, while scores ≥6 had a sensitivity of 96% and specificity of 84% (p<0.001) for the diagnosis of acute heart failure.

ASPECT SCORE: 10-POINT QUANTITATIVE SCORE TO ASSESS ISCHEMIC CHANGES ON CT SCAN

• 10/10 is normal and <4/10 signifies a high risk of bleed with rtPA
• Subtract 1 point for each of the following structures if abnormal within the ischemic hemisphere: caudate, lentiform, insula, internal capsule, MCA 1, 2, 3, 4, 5, 6 regions

ABCD² SCORE TO PREDICT/IDENTIFY INDIVIDUALS AT HIGH RISK OF STROKE FOLLOWING TIA:

• Age: 1 point for age >60 yr
• Blood pressure (at presentation): 1 point for HTN (>140/90 mmHg at initial evaluation)
• Clinical features: 2 points for unilateral weakness, 1 point for speech disturbance without weakness
• Duration of symptoms: 1 point for 10-59 min, 2 points for >60 min
• DM: 1 point

• • Stroke risk: 0-3: low risk, 4-5: moderate risk, 6-7: high risk

APGAR SCORE:

• Mnemonic: APGAR 

• • Appearance (color)
  • Pulse (heart rate)
  • Grimace (irritability)
  • Activity (tone)
  • Respiration (respiratory effort)

MANAGEMENT OF ALCOHOL WITHDRAWAL:

• Monitor using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A) scoring system: Areas of assessment include:
  • Physical (5): nausea and vomiting, tremor, agitation, paroxysmal sweats, headache/fullness in head
  • Psychological/cognitive (2): anxiety, orientation/clouding of sensorium
  • Perceptual (3): tactile disturbances, auditory disturbances, visual disturbances
  • All categories are scored from 0-7 (except: orientation/sensorium 0-4), maximum score of 67 mild <10, moderate 10-20, severe >20.

AUA BPH SYMPTOM SCORE:

• Mnemonic: FUNWISE
  • Frequency
  • Urgency
  • Nocturia
  • Weak stream
  • Intermittency
  • Straining
  • Emptying, incomplete feeling of –
• Each symptom graded out of 5

• • 0-7: Mildly symptomatic
  • 8-19: Moderately symptomatic
  • 20-35: Severely symptomatic
• • Note: dysuria not included in score but is commonly associated with BPH
• Initial alpha-adrenergic antagonist monotherapy for score <20, combination therapy for score >20

ALVARADO SCORING FOR DIAGNOSIS OF ACUTE APPENDICITIS

• Mnemonic: MANTRELS
• • M-migratory pain
  • A- anorexia
  • N- nausea, and vomiting
  • T-tenderness* ( 2 points)
  • R- rebound tenderness
  • E- elevated temperature
  • L- Leukocytosis* ( 2 points)
  • S- shift to left, segmented neutrophils
• All are given 1 point except tenderness and Leukocytosis given 2 points
• A score of > 7 is strongly suggestive of appendicitis.

Also read:

1. Scores in GPNotebook
2. Criteria in NICE
3. Criteria in Statpearls