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Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations
INTRODUCTION: Prehospital stroke scales have been proposed to identify stroke patients with a large vessel occlusion to allow direct transport to an intervention centre capable of endovascular treatment (EVT). It is unclear whether these scales are able to detect not only proximal, but also more dis...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370085/ https://www.ncbi.nlm.nih.gov/pubmed/34414295 http://dx.doi.org/10.1177/23969873211015861 |
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author | Duvekot, Martijne HC Venema, Esmee Lingsma, Hester F Coutinho, Jonathan M van der Worp, H Bart Hofmeijer, Jeannette Bokkers, Reinoud PH van Es, Adriaan CGM van der Lugt, Aad Kerkhoff, Henk Dippel, Diederik WJ Roozenbeek, Bob |
author_facet | Duvekot, Martijne HC Venema, Esmee Lingsma, Hester F Coutinho, Jonathan M van der Worp, H Bart Hofmeijer, Jeannette Bokkers, Reinoud PH van Es, Adriaan CGM van der Lugt, Aad Kerkhoff, Henk Dippel, Diederik WJ Roozenbeek, Bob |
author_sort | Duvekot, Martijne HC |
collection | PubMed |
description | INTRODUCTION: Prehospital stroke scales have been proposed to identify stroke patients with a large vessel occlusion to allow direct transport to an intervention centre capable of endovascular treatment (EVT). It is unclear whether these scales are able to detect not only proximal, but also more distal treatable occlusions. Our aim was to assess the sensitivity of prehospital stroke scales for different EVT-eligible occlusion locations in the anterior circulation. PATIENTS AND METHODS: The MR CLEAN Registry is a prospective, observational study in all centres that perform EVT in the Netherlands. We included adult patients with an anterior circulation stroke treated between March 2014 and November 2017. We used National Institutes of Health Stroke Scale scores at admission to reconstruct previously published prehospital stroke scales. We compared the sensitivity of each scale for different occlusion locations. Occlusions were assessed with CT angiography by an imaging core laboratory blinded to clinical findings. RESULTS: We included 3021 patients for the analysis of 14 scales. All scales had the highest sensitivity to detect internal carotid artery terminus occlusions (ranging from 0.21 to 0.97) and lowest for occlusions of the M2 segment (0.08 to 0.84, p-values < 0.001). Discussion and conclusion: Although prehospital stroke scales are generally sensitive for proximal large vessel occlusions, they are less sensitive to detect more distal occlusions. |
format | Online Article Text |
id | pubmed-8370085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-83700852021-08-18 Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations Duvekot, Martijne HC Venema, Esmee Lingsma, Hester F Coutinho, Jonathan M van der Worp, H Bart Hofmeijer, Jeannette Bokkers, Reinoud PH van Es, Adriaan CGM van der Lugt, Aad Kerkhoff, Henk Dippel, Diederik WJ Roozenbeek, Bob Eur Stroke J Original Research Articles INTRODUCTION: Prehospital stroke scales have been proposed to identify stroke patients with a large vessel occlusion to allow direct transport to an intervention centre capable of endovascular treatment (EVT). It is unclear whether these scales are able to detect not only proximal, but also more distal treatable occlusions. Our aim was to assess the sensitivity of prehospital stroke scales for different EVT-eligible occlusion locations in the anterior circulation. PATIENTS AND METHODS: The MR CLEAN Registry is a prospective, observational study in all centres that perform EVT in the Netherlands. We included adult patients with an anterior circulation stroke treated between March 2014 and November 2017. We used National Institutes of Health Stroke Scale scores at admission to reconstruct previously published prehospital stroke scales. We compared the sensitivity of each scale for different occlusion locations. Occlusions were assessed with CT angiography by an imaging core laboratory blinded to clinical findings. RESULTS: We included 3021 patients for the analysis of 14 scales. All scales had the highest sensitivity to detect internal carotid artery terminus occlusions (ranging from 0.21 to 0.97) and lowest for occlusions of the M2 segment (0.08 to 0.84, p-values < 0.001). Discussion and conclusion: Although prehospital stroke scales are generally sensitive for proximal large vessel occlusions, they are less sensitive to detect more distal occlusions. SAGE Publications 2021-05-13 2021-06 /pmc/articles/PMC8370085/ /pubmed/34414295 http://dx.doi.org/10.1177/23969873211015861 Text en © European Stroke Organisation 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Articles Duvekot, Martijne HC Venema, Esmee Lingsma, Hester F Coutinho, Jonathan M van der Worp, H Bart Hofmeijer, Jeannette Bokkers, Reinoud PH van Es, Adriaan CGM van der Lugt, Aad Kerkhoff, Henk Dippel, Diederik WJ Roozenbeek, Bob Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
title | Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
title_full | Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
title_fullStr | Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
title_full_unstemmed | Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
title_short | Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
title_sort | sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370085/ https://www.ncbi.nlm.nih.gov/pubmed/34414295 http://dx.doi.org/10.1177/23969873211015861 |
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