五种院前卒中筛查量表对院内急性大血管闭塞性缺血性卒中的预测价值 Predictive Value of Five Prehospital Stroke Screening Scales for In-Hospital Acute Large Vessel Occlusive Ischemic Stroke

Abstract

目的 探讨并分析5种院前卒中筛查量表对院内急性大血管闭塞性缺血性卒中的预测价值。 方法 回顾性纳入2015年1月—2022年12月，因非卒中相关疾病收入东台市人民医院并在住院期间因疑似卒中症状激活院内卒中绿色通道的所有患者。采用ROC曲线评估筛查量表对院内急性大血管闭塞性缺血性卒中的预测价值。5种筛查量表分别为卒中现场评估和分类转运量表（field assessment stroke triage for emergency destination，FAST-ED）、快速动脉闭塞评估量表（rapid arterial occlusion evaluation，RACE）、洛杉矶运动量表（Los Angeles motor scale，LAMS）、辛辛那提院前卒中严重程度量表（Cincinnati prehospital stroke severity scale，CPSSS）和院前急性卒中严重程度量表（prehospital acute stroke severity scale，PASS）。 结果 本研究共纳入174例患者，其中54例（31.0%）患者诊断为急性大血管闭塞性缺血性卒中。RACE（AUC 0.888，95%CI 0.849～0.928）和LAMS（AUC 0.859，95%CI 0.812～0.905）对急性大血管闭塞性缺血性卒中的预测效能最高，其次是FAST-ED（AUC 0.820，95%CI 0.768～0.872）、CPSSS（AUC 0.810，95%CI 0.756～0.863）和PASS（AUC 0.786，95%CI 0.727～0.844），三者之间差异无统计学意义。 结论 院前卒中筛查量表在预测院内急性大血管闭塞性缺血性卒中方面均显示出良好的预测能力，其中RACE和LAMS的预测效能最高。 Abstract: Objective To investigate and analyze the predictive value of five prehospital stroke screening scales for in-hospital acute large vessel occlusive ischemic stroke. Methods All patients admitted to Dongtai People’s Hospital for non-stroke-related diseases who activated the in-hospital stroke green channel due to suspected stroke symptoms during hospitalization from January 2015 to December 2022 were retrospectively included. The ROC curve was used to evaluate the predictive value of the screening scales for in-hospital acute large vessel occlusive ischemic stroke. The five scales included field assessment stroke triage for emergency destination (FAST-ED), rapid arterial occlusion evaluation (RACE), Los Angeles motor scale (LAMS), Cincinnati prehospital stroke severity scale (CPSSS), and prehospital acute stroke severity scale (PASS). Results A total of 174 patients were included in this study, of which 54 (31.0%) patients were diagnosed with acute large vessel occlusive ischemic stroke. RACE (AUC 0.888, 95%CI 0.849-0.928) and LAMS (AUC 0.859, 95%CI 0.812-0.905) had the highest predictive efficacy for acute large vessel occlusive ischemic stroke, followed by FAST-ED (AUC 0.820, 95%CI 0.768-0.872), CPSSS (AUC 0.810, 95%CI 0.756-0.863) and PASS (AUC 0.786, 95%CI 0.727-0.844), and there was no significant difference among them. Conclusions The prehospital stroke screening scales showed good predictive efficacy in predicting in-hospital acute large vessel occlusive ischemic stroke, and RACE and LAMS showed the highest predictive efficacy.

Keywords

• 卒中
• 院内卒中
• 大血管闭塞
• 卒中筛查量表
• 预测
• stroke
• in-hospital stroke
• large vessel occlusion
• stroke screening scale
• prediction