Design and Validation of a Prehospital Stroke Scale to Predict Large Arterial Occlusion The Rapid Arterial Occlusion Evaluation Scale
Design and Validation of a Prehospital Stroke Scale to Predict Large Arterial Occlusion The Rapid Arterial Occlusion Evaluation Scale
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DOI：
10.1161/strokeaha.113.003071
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发表时间：
2014-01-01
期刊：
影响因子：
8.3
通讯作者：
Davalos, Antoni
中科院分区：
文献类型：
--
作者：
Perez de la Ossa, Natalia;Carrera, David;Davalos, Antoni
背景和目的我们的目的是开发和验证一个简单的院前卒中量表来预测急性卒中患者是否存在大血管闭塞（LVO）。方法基于美国国立卫生研究院卒中量表（NIHSS）项目设计了快速动脉闭塞评估（RACE）量表，对654例急性缺血性卒中患者进行回顾性队列研究，其中LVO具有较高的预测价值：面神经麻痹（评分0-2）、臂运动功能（0-2）、腿运动功能（0-2）、凝视（0-1）和失语或失认（0-2）。此后，RACE量表在现场进行了前瞻性验证，由受过培训的医疗急救技术人员在357名连续患者中进行了验证，这些患者由急诊医疗服务转移到我们的综合卒中中心。神经科医生在入院时评估卒中严重程度，并通过经颅多普勒、计算机断层扫描或MR血管造影诊断LVO。结果在前瞻性队列中，RACE量表与NIHSS评分呈强相关（r=0.76; P
Background and Purpose We aimed to develop and validate a simple prehospital stroke scale to predict the presence of large vessel occlusion (LVO) in patients with acute stroke.Methods The Rapid Arterial oCclusion Evaluation (RACE) scale was designed based on the National Institutes of Health Stroke Scale (NIHSS) items with a higher predictive value of LVO on a retrospective cohort of 654 patients with acute ischemic stroke: facial palsy (scored 0-2), arm motor function (0-2), leg motor function (0-2), gaze (0-1), and aphasia or agnosia (0-2). Thereafter, the RACE scale was validated prospectively in the field by trained medical emergency technicians in 357 consecutive patients transferred by Emergency Medical Services to our Comprehensive Stroke Center. Neurologists evaluated stroke severity at admission and LVO was diagnosed by transcranial duplex, computed tomography, or MR angiography. Receiver operating curve, sensitivity, specificity, and global accuracy of the RACE scale were analyzed to evaluate its predictive value for LVO.Results In the prospective cohort, the RACE scale showed a strong correlation with NIHSS (r=0.76; P