Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke
Abstract Background Selecting stroke patients with large vessel occlusion (LVO) based on prehospital stroke scales could provide a faster triage and transportation to a comprehensive stroke centre resulting a favourable outcome. We aimed here to explore the detailed severity assessment of Cincinnati...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12873-020-00360-9 |
| _version_ | 1819074453437415424 |
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| author | Gabor Tarkanyi Peter Csecsei Istvan Szegedi Evelin Feher Adam Annus Tihamer Molnar Laszlo Szapary |
| author_facet | Gabor Tarkanyi Peter Csecsei Istvan Szegedi Evelin Feher Adam Annus Tihamer Molnar Laszlo Szapary |
| author_sort | Gabor Tarkanyi |
| collection | DOAJ |
| description | Abstract Background Selecting stroke patients with large vessel occlusion (LVO) based on prehospital stroke scales could provide a faster triage and transportation to a comprehensive stroke centre resulting a favourable outcome. We aimed here to explore the detailed severity assessment of Cincinnati Prehospital Stroke Scale (CPSS) to improve its ability to detect LVO in acute ischemic stroke (AIS) patients. Methods A cross-sectional analysis was performed in a prospectively collected registry of consecutive patients with first ever AIS admitted within 6 h after symptom onset. On admission stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and the presence of LVO was confirmed by computed tomography angiography (CTA) as an endpoint. A detailed version of CPSS (d-CPSS) was designed based on the severity assessment of CPSS items derived from NIHSS. The ability of this scale to confirm an LVO was compared to CPSS and NIHSS respectively. Results Using a ROC analysis, the AUC value of d-CPSS was significantly higher compared to the AUC value of CPSS itself (0.788 vs. 0.633, p < 0.001) and very similar to the AUC of NIHSS (0.795, p = 0.510). An optimal cut-off score was found as d-CPSS≥5 to discriminate the presence of LVO (sensitivity: 69.9%, specificity: 75.2%). Conclusion A detailed severity assessment of CPSS items (upper extremity weakness, facial palsy and speech disturbance) could significantly increase the ability of CPSS to discriminate the presence of LVO in AIS patients. |
| first_indexed | 2024-12-21T18:09:45Z |
| format | Article |
| id | doaj.art-b32270cb1ac04593bb379786bb54924c |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-21T18:09:45Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-b32270cb1ac04593bb379786bb54924c2022-12-21T18:54:49ZengBMCBMC Emergency Medicine1471-227X2020-08-012011610.1186/s12873-020-00360-9Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic strokeGabor Tarkanyi0Peter Csecsei1Istvan Szegedi2Evelin Feher3Adam Annus4Tihamer Molnar5Laszlo Szapary6Department of Neurology, University of PecsDepartment of Neurology, University of PecsDepartment of Neurology, University of DebrecenDepartment of Neurology, University of SzegedDepartment of Neurology, University of SzegedDepartment of Anaesthesiology and Intensive Therapy, University of PecsDepartment of Neurology, University of PecsAbstract Background Selecting stroke patients with large vessel occlusion (LVO) based on prehospital stroke scales could provide a faster triage and transportation to a comprehensive stroke centre resulting a favourable outcome. We aimed here to explore the detailed severity assessment of Cincinnati Prehospital Stroke Scale (CPSS) to improve its ability to detect LVO in acute ischemic stroke (AIS) patients. Methods A cross-sectional analysis was performed in a prospectively collected registry of consecutive patients with first ever AIS admitted within 6 h after symptom onset. On admission stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and the presence of LVO was confirmed by computed tomography angiography (CTA) as an endpoint. A detailed version of CPSS (d-CPSS) was designed based on the severity assessment of CPSS items derived from NIHSS. The ability of this scale to confirm an LVO was compared to CPSS and NIHSS respectively. Results Using a ROC analysis, the AUC value of d-CPSS was significantly higher compared to the AUC value of CPSS itself (0.788 vs. 0.633, p < 0.001) and very similar to the AUC of NIHSS (0.795, p = 0.510). An optimal cut-off score was found as d-CPSS≥5 to discriminate the presence of LVO (sensitivity: 69.9%, specificity: 75.2%). Conclusion A detailed severity assessment of CPSS items (upper extremity weakness, facial palsy and speech disturbance) could significantly increase the ability of CPSS to discriminate the presence of LVO in AIS patients.http://link.springer.com/article/10.1186/s12873-020-00360-9Acute strokeLarge vessel occlusionStroke scalesPrehospitalEmergency medicineNeurology |
| spellingShingle | Gabor Tarkanyi Peter Csecsei Istvan Szegedi Evelin Feher Adam Annus Tihamer Molnar Laszlo Szapary Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke BMC Emergency Medicine Acute stroke Large vessel occlusion Stroke scales Prehospital Emergency medicine Neurology |
| title | Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke |
| title_full | Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke |
| title_fullStr | Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke |
| title_full_unstemmed | Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke |
| title_short | Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke |
| title_sort | detailed severity assessment of cincinnati prehospital stroke scale to detect large vessel occlusion in acute ischemic stroke |
| topic | Acute stroke Large vessel occlusion Stroke scales Prehospital Emergency medicine Neurology |
| url | http://link.springer.com/article/10.1186/s12873-020-00360-9 |
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