Prisma Health-Upstate, 701 Grove Rd, Greenville, SC 29605, USA.
Prisma Health-Upstate, 701 Grove Rd, Greenville, SC 29605, USA.
J Stroke Cerebrovasc Dis. 2022 Nov;31(11):106746. doi: 10.1016/j.jstrokecerebrovasdis.2022.106746. Epub 2022 Sep 8.
Several stroke assessments have been designed for Emergency Medical Services to identify stroke patients with large vessel occlusion in the prehospital setting. The Rapid Arterial oCclusion Evaluation scale was developed in Spain, yet only few United States-based studies have confirmed findings from Spain. This study was designed to determine if the Rapid Arterial oCclusion Evaluation scale is a valid prehospital stroke assessment for identifying large vessel occlusion patients in South Carolina, USA.
The performance of the Rapid Arterial oCclusion Evaluation scale was determined by calculating the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy at each score. The discriminative power of the Rapid Arterial oCclusion Evaluation score was evaluated using receiver operator characteristics. Comparison of the Rapid Arterial oCclusion Evaluation Scale to the National Institute of Health Stroke Scale was assessed using the Spearman's coefficient.
The Rapid Arterial oCclusion Evaluation scale had an acceptable discriminative power (c = 0.71). A score of ≥5 had a sensitivity of 0.71, specificity of 0.65, positive predictive value of 0.24, negative predictive value of 0.93, and accuracy of 0.66. There was a significant correlation between the Rapid Arterial Cclusion Evaluation score and the National Institute of Health Stroke Scale (rho = 0.60).
The Rapid Arterial oCclusion Evaluation scale performed comparably to the National Institute of Health Stroke Scale in South Carolina; however, performed lower than Spain. Future studies should investigate patient demographics and emergency medical services training to determine if these variables contribute to the results found in this study.
有几种针对急诊医疗服务的卒中评估方法可用于在院前环境中识别大血管闭塞的卒中患者。Rapid Arterial oCclusion Evaluation（RACE）量表是在西班牙开发的，但仅有少数基于美国的研究证实了西班牙的研究结果。本研究旨在确定 RACE 量表是否是一种有效的美国南卡罗来纳州的院前卒中评估方法，可用于识别大血管闭塞患者。
通过计算各评分的敏感度、特异度、阳性预测值、阴性预测值和准确率来确定 RACE 量表的性能。使用受试者工作特征曲线评估 RACE 评分的判别能力。使用 Spearman 系数比较 RACE 量表和 National Institute of Health Stroke Scale（NIHSS）量表。
RACE 量表具有可接受的判别能力（c=0.71）。评分≥5 时的敏感度为 0.71，特异度为 0.65，阳性预测值为 0.24，阴性预测值为 0.93，准确率为 0.66。RACE 评分与 NIHSS 量表之间存在显著相关性（rho=0.60）。
RACE 量表在南卡罗来纳州与 NIHSS 量表的表现相当，但低于西班牙。未来的研究应调查患者人口统计学和急诊医疗服务培训，以确定这些变量是否对本研究中的结果有影响。
