Abstract WMP67: Stroke Screening Tools Have High Specificity for Detecting Large Vessel Occlusion in a Southeastern US Prospective Cohort Study

• Published in: Stroke (1970) 2016-02, Vol.47 (suppl_1)
• Main Authors: Qureshi, Sakib, Janjua, Ahmad Umair, Raza, Syed Ali, Brasher, Cynthia, Anderson, Aaron, Belagaje, Samir, Ranagaraju, Srikant, Frankel, Michael R, Nogueira, Raul, Haussen, Diogo C, Greene, James, MacDonald, Paul, Javalkar, Vijayakumar, Dharia, Robin, Obideen, Mahmoud, Dehkharghani, Seena, Camp, Debbie, Lugtu, James, Ehleben, Carole, Nahab, Fadi
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.47.suppl_1.wmp67

Abstract only Introduction: Previously reported stroke screening tools used to identify large vessel occlusion (LVO) have been developed based on retrospective analyses or cohorts enrolled in a clinical trial. Hypothesis: Stroke screening tools may have lower specificity for detection of LVO when tested in a prospective cohort study of patients identified by emergency medical services (EMS) to have stroke signs and symptoms. Methods: Consecutive patients presenting to a stroke center with stroke symptoms or a positive FAST screen by EMS within 6 hours from stroke onset or wakeup were included in this prospective analysis. All patients were initially evaluated by a neurology attending or resident and underwent non-contrast CT (NCCT). Patients identified to have a stroke mimic on initial assessment or hemorrhagic stroke on NCCT did not undergo intracranial large artery imaging (iLAI); all remaining patients underwent iLAI. Sensitivity and specificity for LVO with the following screens were assessed: NIHSS ≥ 15, LAMS ≥ 4, RACE ≥ 5 and CPSSS ≥2. Results: Of 92 patients (mean age 69±17 years, mean NIHSS 8) evaluated over the 3 month study period, 41 (45%) were identified to have a stroke mimic and 9 (10%) had a hemorrhagic stroke on NCCT; 19 (21%) patients had LVO. The remaining 42 patients underwent iLAI within