Hagberg Guri, Ihle-Hansen Haakon, Abzhandadze Tamar, Reinholdsson Malin, Viktorisson Adam, Ihle-Hansen Hege, Stibrant Sunnerhagen Katharina
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.
Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Oslo, Norway.
BMJ Neurol Open. 2024 Apr 15;6(1):e000574. doi: 10.1136/bmjno-2023-000574. eCollection 2024.
The shift towards milder strokes and studies suggesting that stroke symptoms vary by age and sex may challenge the Face-Arm-Speech Time (FAST) coverage. We aimed to study the proportion of stroke cases admitted with FAST symptoms, sex and age differences in FAST presentation and explore any additional advantage of including new item(s) from the National Institute of Health Stroke Scale (NIHSS) to the FAST algorithm.
This registry-based study included patients admitted with acute stroke to Sahlgrenska University Hospital (November 2014 to June 2019) with NIHSS items at admission. FAST symptoms were extracted from the NIHSS at admission, and sex and age differences were explored using descriptive statistics.
Of 5022 patients, 46% were women. Median NIHSS at admission for women was (2 (8-0) and for men 2 (7-0)). In total, 2972 (59%) had at least one FAST symptom, with no sex difference (p=0.22). No sex or age differences were found in FAST coverage when stratifying for stroke severity. 52% suffered mild strokes, whereas 30% had FAST symptoms. The most frequent focal NIHSS items not included in FAST were sensory (29%) and visual field (25%) and adding these or both in modified FAST algorithms led to a slight increase in strokes captured by the algorithms (59%-67%), without providing enhanced prognostic information.
60% had at least one FAST symptom at admission, only 30% in mild strokes, with no sex or age difference. Adding new items from the NIHSS to the FAST algorithm led only to a slight increase in strokes captured.
向轻度中风的转变以及一些研究表明中风症状因年龄和性别而异，这可能对脸-臂-言语时间（FAST）覆盖范围构成挑战。我们旨在研究出现FAST症状的中风病例比例、FAST表现中的性别和年龄差异，并探讨将美国国立卫生研究院卒中量表（NIHSS）的新项目纳入FAST算法是否有任何额外优势。
这项基于登记处的研究纳入了2014年11月至2019年6月在萨尔格伦斯卡大学医院因急性中风入院且入院时有NIHSS项目的患者。入院时从NIHSS中提取FAST症状，并使用描述性统计方法探讨性别和年龄差异。
在5022名患者中，46%为女性。女性入院时NIHSS中位数为2（8 - 0），男性为2（7 - 0）。总共有2972名（59%）患者至少有一项FAST症状，无性别差异（p = 0.22）。按中风严重程度分层时，FAST覆盖范围未发现性别或年龄差异。52%的患者为轻度中风，而30%有FAST症状。FAST未包括的最常见局灶性NIHSS项目是感觉（29%）和视野（25%），在改良的FAST算法中加入这些项目或两者都加入，会使算法捕获的中风略有增加（59% - 67%），但未提供增强的预后信息。
60%的患者入院时至少有一项FAST症状，轻度中风患者中只有30%，无性别或年龄差异。将NIHSS的新项目添加到FAST算法中仅使捕获的中风略有增加。
