Stroke: FAST-ED量表可用来识别大血管闭塞性卒中患者

2016-10-29 MedSci MedSci原创

背景:大血管闭塞卒中患者(LVOS)可以更好地通过直接转移到血管内中心治疗,避免在初级及综合卒中中心延误。然而,准确的卒中分流仍然具有挑战性。研究者的目的是开发一个简单的量表来识别LVOS。方法:FAST-ED量表是基于美国国立卫生院卒中量表(NIHSS)对LVOS有较高的预测价值,并且在STOPStroke队列中进行验证,其中患者在脑卒中发病24小时内行CT血管造影。LVOS被完全闭塞包括颈内动

背景:大血管闭塞卒中患者(LVOS)可以更好地通过直接转移到血管内中心治疗,避免在初级及综合卒中中心延误。然而,准确的卒中分流仍然具有挑战性。研究者的目的是开发一个简单的量表来识别LVOS。

方法:FAST-ED量表是基于美国国立卫生院卒中量表(NIHSS)对LVOS有较高的预测价值,并且在STOPStroke队列中进行验证,其中患者在脑卒中发病24小时内行CT血管造影。LVOS被完全闭塞包括颈内动脉颅内段,大脑中动脉M1,大脑中动脉2或基底动脉。排除部分,双侧,前+后循环闭塞的患者。分别比较NIHSS分数,快速评价动脉闭塞(RACE)量表和辛辛那提院前卒中严重程度量表(CPSS)与FAST-ED量表的接受者操作特性曲线、灵敏度、特异性、阳性预测值和阴性预测值。

结果:727例患者中,240(33%)符合LVO的条件。FAST-ED与 NIHSS评分预测LVO的准确性一致,准确度高于RACE及CPSS(ROC曲线:FAST-ED = 0.81;NIHSS评分= 0.80,P = 0.28;RACE= 0.77,P = 0.02;和CPSS = 0.75,P = 0.002)。FAST-ED≥4 ,RACE≥5,CPSS≥2的敏感性分别为0.60,0.55,0.56特异性分别为0.89,0.87,0.85阳性预测值分别0.72,0.68,0.65阴性预测值为分别0.82,0.79和0.78。

结论:如果能在该领域的成功验证,FAST-ED是一个简单的量表,医疗急救专业人员可以此量表来识别LVOS,使患者快速分流。

原始出处:

Lima FO, Silva GS, et al. Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes. Stroke. 2016 Aug


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    2017-06-05 JR19860219
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    2016-12-14 kkunny
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    2017-08-24 gracezdd
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