Zangi Mahdi, Karimi Somayeh, Mirbaha Sahar, Sotoodehnia Mehran, Rasooli Fatemeh, Baratloo Alireza
Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Turk J Emerg Med. 2020 Dec 1;21(1):1-5. doi: 10.4103/2452-2473.301914. eCollection 2021 Jan-Mar.
In this study, we aimed to investigate the accuracy of recognition of stroke in the Emergency Room (ROSIER) Scale in the diagnosis of patients with acute ischemic stroke (AIS) transferred to the emergency department (ED).
The present study was a multicenter study. Records from patients suspected of stroke, who referred to the ED were reviewed. Demographic, clinical, and diagnostic data were extracted and then entered in checklists. ROSIER Scale was used to evaluate the possible diagnosis in this study. The definitive diagnosis of a stroke was made based on neurologist's assessment and clinical and neuroimaging findings, mainly brain magnetic resonance imaging (MRI). Receiver operating characteristic (ROC) curve analysis was conducted for assessing the accuracy of ROSIER in discrimination of stroke.
The data of 356 suspected stroke patients were analyzed. Of all, 186 patients (52.2%) were male, and the mean age was 65.2 (standard deviation = 14.0) years ranging from 26 to 95 years. One hundred and fifty-one patients (42.4%) had AIS based on the final diagnosis. The area under the ROC curve was 0.85. The best cutoff point for ROSIER scale was ≥1 with a sensitivity of 85.4% (95% confidence interval [CI]: 78.8, 90.6%) and specificity of 65.8% (95% CI: 58.9, 72.3%).
Based on the findings, although the best cutoff point was the same as the original (derivation) study, its sensitivity (85.4% vs. 92%) and specificity (65.8% vs. 86%) were considerably lower.
在本研究中，我们旨在调查急诊室卒中识别（ROSIER）量表在诊断转诊至急诊科（ED）的急性缺血性卒中（AIS）患者时的准确性。
本研究为多中心研究。回顾了转诊至急诊科的疑似卒中患者的记录。提取人口统计学、临床和诊断数据，然后录入检查表。本研究使用ROSIER量表评估可能的诊断。卒中的最终诊断基于神经科医生的评估以及临床和神经影像学检查结果，主要是脑磁共振成像（MRI）。进行受试者操作特征（ROC）曲线分析以评估ROSIER量表在鉴别卒中方面的准确性。
分析了356例疑似卒中患者的数据。其中，186例患者（52.2%）为男性，平均年龄为65.2岁（标准差 = 14.0），年龄范围为26至95岁。根据最终诊断，151例患者（42.4%）患有AIS。ROC曲线下面积为0.85。ROSIER量表的最佳截断点为≥1，灵敏度为85.4%（95%置信区间[CI]：78.8，90.6%），特异度为65.8%（95%CI：58.9，72.3%）。
基于研究结果，尽管最佳截断点与原（推导）研究相同，但其灵敏度（85.4%对92%）和特异度（65.8%对86%）显著降低。
