Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
The Prehospital Ambulance Stroke Test Vs. the Cincinnati Prehospital Stroke Scale: A Diagnostic Accuracy Study Publisher



Karimi S1, 2 ; Motamed H3 ; Aliniagerdroudbari E4 ; Babaniamansour S5 ; Jami A4 ; Baratloo A1, 2
Authors
Show Affiliations
Authors Affiliations
  1. 1. Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  4. 4. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran

Source: Australasian Journal of Paramedicine Published:2020


Abstract

Introduction Immediate diagnosis of stroke is crucial in reducing its morbidity and mortality rate. There are various pre-hospital assessment tools, such as the Prehospital Ambulance Stroke Test (PreHAST) and the Cincinnati Prehospital Stroke Scale (CPSS) used to identify stroke early in the chain of care. The aim of this study is to compare the accuracy of PreHAST with CPSS in diagnosing stroke. Methods In this diagnostic accuracy study patients with suspicion of stroke were included in this study. In CPSS, the criterion used to indicate stroke are facial droop, speech and arm drift. In PreHAST it is eye position, visual field, facial palsy, right and left arms paresis, right and left legs paresis, sensory and speech. After data collection, sensitivity and specificity were calculated using standard formulae. Different cut-off points for the best diagnostic accuracy were examined in both CPSS and PreHAST. Results In this study, 883 patients were investigated. The results demonstrated that in CPSS, the highest specificity and sensitivity was for facial droop (84.9%) and arm drift (82.7%); and in PreHAST it was eye position (99.6%) and facial palsy (49.2%). The best predictor of stroke in CPSS with highest sensitivity (78.5%) and specificity (66%) was a cut-off point of 1.5 (AUC: 0.744) (p<0.01(. In PreHAST, the highest sensitivity (68.4%) was a cut-off point of 2.5 and the highest specificity (90.2%) was a cut-off point of 5.5 (AUC: 0.775) (p<0.01). Conclusion Both PreHAST and CPSS are useful screening tools in the pre-hospital diagnosis of stroke. In addition to high sensitivity, these tests provide a grading system in which higher cut-off points lead to higher specificity. © 2020, Paramedics Australasia. All rights reserved.
Related Docs
1. A Multicenter Diagnostic Accuracy Study on Prehospital Stroke Screening Scales, Archives of Iranian Medicine (2021)
2. The Validity of Recognition of Stroke in the Emergency Room (Rosier) Scale in the Diagnosis of Iranian Patients With Acute Ischemic Stroke in the Emergency Department, Turkish Journal of Emergency Medicine (2021)
3. A Nomogram-Based Clinical Tool for Acute Ischemic Stroke Screening in Prehospital Setting, Current Journal of Neurology (2023)
4. Two-Stage Clinical Model for Screening the Suspected Cases of Acute Ischemic Stroke in Need of Imaging in Emergency Department; a Cross-Sectional Study, Archives of Academic Emergency Medicine (2023)
5. Accuracy of Prehospital Ambulance Stroke Test in Terms of Diagnosis of Patients With Acute Ischemic Stroke: A Multi-Center Study, Current Journal of Neurology (2020)
6. The Value of Predictive Instruments in the Screening of Acute Stroke: An Umbrella Review on Previous Systematic Reviews, Frontiers in Emergency Medicine (2022)
Experts (# of related papers)
View all Related Experts
Alireza Baratloo (6)
Somayeh Karimi (5)