Tárkányi Gábor, Karádi Zsófia Nozomi, Csécsei Péter, Bosnyák Edit, Fehér Gergely, Molnár Tihamér, Szapáry László
Department of Neurology, University of Pécs, Pécs.
Centre for Occupational Medicine, University of Pécs, Pécs.
Ideggyogy Sz. 2021 Mar 30;74(3-4):99-103. doi: 10.18071/isz.74.0099.
Rapid changes of stroke management in recent years facilitate the need for accurate and easy-to-use screening methods for early detection of large vessel occlusion (LVO) in acute ischemic stroke (AIS). Our aim was to evaluate the ability of various stroke scales to discriminate an LVO in AIS.
We have performed a cross-sectional, observational study based on a registry of consecutive patients with first ever AIS admitted up to 4.5 hours after symptom onset to a comprehensive stroke centre. The diagnostic capability of 14 stroke scales were investigated using receiver operating characteristic (ROC) analysis.
Area under the curve (AUC) values of NIHSS, modified NIHSS, shortened NIHSS-EMS, sNIHSS-8, sNIHSS-5 and Rapid Arterial Occlusion Evaluation (RACE) scales were among the highest (>0.800 respectively). A total of 6 scales had cut-off values providing at least 80% specificity and 50% sensitivity, and 5 scales had cut-off values with at least 70% specificity and 75% sensitivity.
Certain stroke scales may be suitable for discriminating an LVO in AIS. The NIHSS and modified NIHSS are primarily suitable for use in hospital settings. However, sNIHSS-EMS, sNIHSS-8, sNIHSS-5, RACE and 3-Item Stroke Scale (3I-SS) are easier to perform and interpret, hence their use may be more advantageous in the prehospital setting. Prospective (prehospital) validation of these scales could be the scope of future studies.
近年来，卒中治疗方法迅速变化，这使得需要准确且易于使用的筛查方法来早期检测急性缺血性卒中（AIS）中的大血管闭塞（LVO）。我们的目的是评估各种卒中量表区分AIS中LVO的能力。
我们基于一个对症状发作后4.5小时内首次因AIS入院的连续患者的登记系统进行了一项横断面观察性研究。使用受试者操作特征（ROC）分析研究了14种卒中量表的诊断能力。
美国国立卫生研究院卒中量表（NIHSS）、改良NIHSS、简化NIHSS-急救医疗服务版（NIHSS-EMS）、sNIHSS-8、sNIHSS-5和快速动脉闭塞评估（RACE）量表的曲线下面积（AUC）值最高（分别>0.800）。共有6种量表的截断值具有至少80%的特异性和50%的敏感性，5种量表的截断值具有至少70%的特异性和75%的敏感性。
某些卒中量表可能适用于区分AIS中的LVO。NIHSS和改良NIHSS主要适用于医院环境。然而，sNIHSS-EMS、sNIHSS-8、sNIHSS-5、RACE和三项卒中量表（3I-SS）更易于实施和解读，因此它们在院前环境中的使用可能更具优势。这些量表的前瞻性（院前）验证可能是未来研究的范围。
