Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Design and Validation of a Simple Scale to Predict Large Vessel Occlusion in Patients with Acute Ischemic Stroke—— Prehospital Acute Stroke Triage Scale
First author：Shiyu Li
Corresponding author：Yongjun Wang
essential_information
2020-04-04
Published articles
Journal：Atherosclerosis
Publication type: Original Research
IF(IF): 5.162
PMID: 32652342 Link To Pubmed Full text Download
Background And Purpose
Acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) have severe symptoms and poor prognosis. Early recognition of these patients in the prehospital setting contribute to rapid triage to comprehensive stroke centers (CSC) with endovascular therapy (EVT) conditions. We aimed to develop a simple and efficient scale to identify LVO and compare with other published scales.
Method
The Prehospital Acute Stroke Triage Scale (PAST) scale was designed based on the National Institutes of Health Stroke Scale (NIHSS) items with higher predictive values of LVO. Information of intracranial vessel status was retrospectively collected from medical records of patients with acute ischemic stroke (AIS) in Beijing Tiantan hospital. Receiver operating characteristics (ROC) curve was used to determine and compare the discriminative ability of each scale.
Conclusion
PAST scale is relatively simple and has comparable ability for recognizing large vessel occlusion to more complex NIHSS.
Main results
A total of 1313 patients diagnosed with acute ischemic stroke were included in this study. Half of the patients were used to design and the other were used to validate PAST scale. The PAST scale showed a comparable predictive ability to NIHSS for detecting LVO (c-statistics, 0.8607 vs 0.8715, p=0.1889). A FAST scale ≥2 showed sensitivity 0.85209, specificity 0.76301 and accuracy 0.80518. PAST scale also show good performance in subgroup analysis based on the time of onset, infarct location and the way of vascular examination.