London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 653 583 Acute stroke: emergency management, stroke units and complications Withdrawn! 584 Acute stroke: emergency management, stroke units and complications Comparison of stroke scores in a pre- and intra-hospital emergency setting J.C. Purrucker1, C. Hametner2, A. Engelbrecht3, M. Priglinger4, M. Bartz5, E. Popp6, S. Poli7 University Hospital Heidelberg, Department of Neurology, Heidelberg, GERMANY1, Univer-sity Hospital Heidelberg, Department of Neurology, Heidelberg, GERMANY2, University Hospital Heidelberg, Department of Neurology, Heidelberg, GERMANY3, University Hospital Heidelberg, Department of Neurology, Heidelberg, GERMANY4, University Hospital Heidelberg, Department of Neurology, Heidelberg, GERMANY5, University Hospital Heidelberg, Department of Anaesthe-siology, Heidelberg, GERMANY6, University Hospital Tübingen, Department of Neurology, Tübin-gen, GERMANY7 Background: Correct and rapid prehospital identification of stroke allows early preparation of acute stroke teams. Special stroke scores have been developed and validated for this purpose. The aim of our study was to compare the sensitivity and specificity of stroke identification with the Cincinnati Prehospital Stroke Scale (CPSS), the Face Arm Speech Test in a modified version (mFAST), the Los Angeles Prehospital Stroke Screen (LAPSS), the Melbourne Ambulance Stroke Screen (MASS), the Recognition of Stroke in the Emergency Room score (ROSIER) and the full and shortened NIH Stroke Scale (NIHSS) with 15, 8 and 5 items. Methods: Retrospective analysis including consecutive data sets of 774 patients first assessed by prehospital emergency physicians. Hospital discharge diagnosis was available in 741 cases. CPSS, MASS, LAPSS and the mFAST score were calculated at both the prehospital and the neurologic emergency room level, whereas the other stroke scores where assessed only at the ER level. Results: CPSS, mFAST and MASS provided best prehospital sensitivity for stroke identification (86.9, 88.7 and 84.9% respectively) while specificity was low (60.7, 60.2 and 63 %). In contrast, high specificity was reached with the LAPSS (89.7%), but sensitivity was low (62.6%). At the ER level, NIHSS provided best sensitivity of stroke identification (91.1%). General trends were con-sistently found when dichotomizing the population in patients < 70 and => 70 years old or patients having a modified Rankin Score (mRS) of <= 2 and those with a mRS > 2. Sensitivity of stroke identification increased with the age and disability of the patients. Conclusion: Complex stroke scores as the MASS did not provide a better sensitivity than the more simplified CPSS or mFAST. Individual aspects of all eight stroke scores are shown in detail.
Karger_ESC London_2013
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