Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
J Neurointerv Surg. 2019 Jul;11(7):659-663. doi: 10.1136/neurintsurg-2018-014482. Epub 2018 Dec 4.
The Speech Arm Vision Eyes (SAVE) scale, a 4-item clinical scale emphasizing binary scoring and avoidance of nuanced examination distinctions, predicts LVOs with similar characteristics as more complex scales.
Receiver operating characteristic analyses of the prospective STOPStroke study assessed the ability of the SAVE scale and other published scales to predict LVO. We identified scale thresholds with positive likelihood ratios with 95% confidence intervals of ≥5.0 or negative likelihood ratios with 95% confidence intervals of ≤0.5.
735patients were studied. LVO prevalence was 33%. Area under the curve was 0.79 for SAVE, 0.82 for FAST-ED, 0.80 for mNIHSS and NIHSS, and lower for all other scales. SAVE=4, EMSA=6, mNIHSS≥10, NIHSS≥16, and RACE≥8 had positive likelihood ratios with 95% confidence intervals ≥5.0. SAVE≥2, CPSS≥2, C-STAT≥1, EMSA≥4, FAST-ED≥3, G-FAST≥3, mNIHSS≥6, NIHSS≥9, PASS≥1, RACE≥2, VAN=1, and 3I-SS≥1 had negative likelihood ratios with 95% confidence intervals ≤0.5.
SAVE=4 performed similarly to more complex scales at predicting LVO. Other simplified scales did not have thresholds with positive likelihood ratios with 95% confidence intervals ≥5.0. Validation is need in a prehospital cohort of patients with suspected stroke.
Speech Arm Vision Eyes（SAVE）量表是一个包含 4 个项目的临床量表，强调二分类评分且避免细微的检查区别，可预测具有相似特征的 LVOs，与更复杂的量表相当。
前瞻性 STOPStroke 研究的受试者工作特征分析评估了 SAVE 量表和其他已发表量表预测 LVO 的能力。我们确定了阳性似然比（95%置信区间≥5.0）和阴性似然比（95%置信区间≤0.5）的量表阈值。
共纳入 735 例患者，LVO 患病率为 33%。SAVE、FAST-ED、mNIHSS 和 NIHSS 的曲线下面积分别为 0.79、0.82、0.80，其他量表的 AUC 均较低。SAVE=4、EMSAS=6、mNIHSS≥10、NIHSS≥16 和 RACE≥8 的阳性似然比（95%置信区间≥5.0）。SAVE≥2、CPSS≥2、C-STAT≥1、EMSAS≥4、FAST-ED≥3、G-FAST≥3、mNIHSS≥6、NIHSS≥9、PASS≥1、RACE≥2、VAN=1 和 3I-SS≥1 的阴性似然比（95%置信区间≤0.5）。
SAVE=4 预测 LVO 的性能与更复杂的量表相当。其他简化量表没有阳性似然比（95%置信区间≥5.0）的阈值。需要在疑似卒中的院前患者队列中进行验证。
