Optimizing the Recognition and Treatment of In-Hospital Stroke: Evaluation of the 2CAN Score

•Eighty percent of inpatients for whom the Brain Attack Team was called had undergone a recent procedure, with 58% having had a cardiac or vascular procedure.•Eighty-eight percent of inpatient stroke alerts during our five-year study period were found to have had stroke, with 12% receiving a final diagnosis of stroke mimic.•A 2CAN score (Chang 2018) of ≥ 2 had a sensitivity of 83.5%, specificity of 23.1%, PPV of 89.0%, and NPV of 15.8% for stroke in our cohort.•A total of 9.3% of in-hospital stroke patients received emergent reperfusion therapy in the form of tPA, mechanical thrombectomy, or both.