Martin Faurholdt Gude

The Prehospital Stroke Score and telephone conference: A prospective validation

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The Prehospital Stroke Score and telephone conference : A prospective validation. / Gude, Martin F; Blauenfeldt, Rolf A; Behrndtz, Anne B et al.

I: Acta Neurologica Scandinavica, Bind 145, Nr. 5, 05.2022, s. 541-550.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{fd69ddd4e94d4b2db658d8519e1c6f5f,
title = "The Prehospital Stroke Score and telephone conference: A prospective validation",
abstract = "OBJECTIVES: The main aim of the study is to investigate the performance of a two-part stroke scale for screening and subsequent severity assessment combined with a telephone conference (teleconference).MATERIALS AND METHODS: During a 6-month period, we prospectively tested the Prehospital Stroke Score (PreSS). PreSS part 1 is designed to identify stroke or TIA in a prehospital setting. PreSS part 2 is a stroke severity scale designed to identify large-vessel occlusion (LVO). PreSS was performed by emergency medical service (EMS) providers prior to a teleconference with a stroke neurologist.RESULTS: Combined teleconference and PreSS part 1 were performed on 79.3% of all patients diagnosed with stroke/TIA, and 99.1% of the patients with positive scores were subsequently PreSS part 2 scored. PreSS part 1 and teleconference had a sensitivity to identify stroke/TIA of 89.3% (95% CI 85.7-92.2), specificity of 64.5% (95% CI 59.3-69.5), and an area under the curve (AUC) of 0.80 (95% CI 0.77-0.83). Regarding LVO, PreSS part 1 with teleconference recognized 96.7% (95% CI 88.7-99.6) of all cases as stroke. PreSS part 2 had a sensitivity of 55.7% (95% CI 42.4-68.5), specificity of 91.5% (95% CI 89.0-93.6), and AUC of 0.86 (95% CI 0.82-0.90) for identification of LVO.CONCLUSIONS: PreSS was feasible and the sensitivity for stroke/TIA and LVO was high to moderate providing an overall high precision. Almost all LVO cases were ensured acute stroke admission. The high specificity for LVO could be useful for determining transfers strategies.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence when evaluating PreSS combined with teleconference.",
keywords = "acute stroke, arterial occlusive diseases/diagnosis, emergency medical services, prospective studies, DESIGN, SERVICES, FIELD, diagnosis, LARGE-VESSEL OCCLUSION, CARE, arterial occlusive diseases, SCALE, VALIDITY, Predictive Value of Tests, Stroke/diagnosis, Telephone, Humans, Brain Ischemia/diagnosis, Retrospective Studies, Emergency Medical Services",
author = "Gude, {Martin F} and Blauenfeldt, {Rolf A} and Behrndtz, {Anne B} and Nielsen, {Casper N} and Lasse Speiser and Simonsen, {Claus Z} and Johnsen, {S{\o}ren P} and Hans Kirkegaard and Grethe Andersen",
note = "{\textcopyright} 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2022",
month = may,
doi = "10.1111/ane.13580",
language = "English",
volume = "145",
pages = "541--550",
journal = "Acta Neurologica Scandinavica",
issn = "0001-6314",
publisher = "Wiley-Blackwell Munksgaard",
number = "5",

}

RIS

TY - JOUR

T1 - The Prehospital Stroke Score and telephone conference

T2 - A prospective validation

AU - Gude, Martin F

AU - Blauenfeldt, Rolf A

AU - Behrndtz, Anne B

AU - Nielsen, Casper N

AU - Speiser, Lasse

AU - Simonsen, Claus Z

AU - Johnsen, Søren P

AU - Kirkegaard, Hans

AU - Andersen, Grethe

N1 - © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2022/5

Y1 - 2022/5

N2 - OBJECTIVES: The main aim of the study is to investigate the performance of a two-part stroke scale for screening and subsequent severity assessment combined with a telephone conference (teleconference).MATERIALS AND METHODS: During a 6-month period, we prospectively tested the Prehospital Stroke Score (PreSS). PreSS part 1 is designed to identify stroke or TIA in a prehospital setting. PreSS part 2 is a stroke severity scale designed to identify large-vessel occlusion (LVO). PreSS was performed by emergency medical service (EMS) providers prior to a teleconference with a stroke neurologist.RESULTS: Combined teleconference and PreSS part 1 were performed on 79.3% of all patients diagnosed with stroke/TIA, and 99.1% of the patients with positive scores were subsequently PreSS part 2 scored. PreSS part 1 and teleconference had a sensitivity to identify stroke/TIA of 89.3% (95% CI 85.7-92.2), specificity of 64.5% (95% CI 59.3-69.5), and an area under the curve (AUC) of 0.80 (95% CI 0.77-0.83). Regarding LVO, PreSS part 1 with teleconference recognized 96.7% (95% CI 88.7-99.6) of all cases as stroke. PreSS part 2 had a sensitivity of 55.7% (95% CI 42.4-68.5), specificity of 91.5% (95% CI 89.0-93.6), and AUC of 0.86 (95% CI 0.82-0.90) for identification of LVO.CONCLUSIONS: PreSS was feasible and the sensitivity for stroke/TIA and LVO was high to moderate providing an overall high precision. Almost all LVO cases were ensured acute stroke admission. The high specificity for LVO could be useful for determining transfers strategies.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence when evaluating PreSS combined with teleconference.

AB - OBJECTIVES: The main aim of the study is to investigate the performance of a two-part stroke scale for screening and subsequent severity assessment combined with a telephone conference (teleconference).MATERIALS AND METHODS: During a 6-month period, we prospectively tested the Prehospital Stroke Score (PreSS). PreSS part 1 is designed to identify stroke or TIA in a prehospital setting. PreSS part 2 is a stroke severity scale designed to identify large-vessel occlusion (LVO). PreSS was performed by emergency medical service (EMS) providers prior to a teleconference with a stroke neurologist.RESULTS: Combined teleconference and PreSS part 1 were performed on 79.3% of all patients diagnosed with stroke/TIA, and 99.1% of the patients with positive scores were subsequently PreSS part 2 scored. PreSS part 1 and teleconference had a sensitivity to identify stroke/TIA of 89.3% (95% CI 85.7-92.2), specificity of 64.5% (95% CI 59.3-69.5), and an area under the curve (AUC) of 0.80 (95% CI 0.77-0.83). Regarding LVO, PreSS part 1 with teleconference recognized 96.7% (95% CI 88.7-99.6) of all cases as stroke. PreSS part 2 had a sensitivity of 55.7% (95% CI 42.4-68.5), specificity of 91.5% (95% CI 89.0-93.6), and AUC of 0.86 (95% CI 0.82-0.90) for identification of LVO.CONCLUSIONS: PreSS was feasible and the sensitivity for stroke/TIA and LVO was high to moderate providing an overall high precision. Almost all LVO cases were ensured acute stroke admission. The high specificity for LVO could be useful for determining transfers strategies.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence when evaluating PreSS combined with teleconference.

KW - acute stroke

KW - arterial occlusive diseases/diagnosis

KW - emergency medical services

KW - prospective studies

KW - DESIGN

KW - SERVICES

KW - FIELD

KW - diagnosis

KW - LARGE-VESSEL OCCLUSION

KW - CARE

KW - arterial occlusive diseases

KW - SCALE

KW - VALIDITY

KW - Predictive Value of Tests

KW - Stroke/diagnosis

KW - Telephone

KW - Humans

KW - Brain Ischemia/diagnosis

KW - Retrospective Studies

KW - Emergency Medical Services

U2 - 10.1111/ane.13580

DO - 10.1111/ane.13580

M3 - Journal article

C2 - 35023151

VL - 145

SP - 541

EP - 550

JO - Acta Neurologica Scandinavica

JF - Acta Neurologica Scandinavica

SN - 0001-6314

IS - 5

ER -