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Are you suffering from a large arterial occlusion?Please raise your arm!

Stroke & Vascular Neurology 2018年第4期3卷 215-221页

作者： charith cooray Michael V Mazya Matteo Bottai Jan F Scheitz Azmil H Abdul-Rahim Tiago Prazeres Moreira Robert Mikulik Antonin Krajina Miroslava Nevsimalova Danilo Toni Nils Wahlgren Niaz Ahmed Department of Clinical Neurosciences Karolinska InstitutetStockholmSweden Department of Neurology Karolinska University HospitalStockholmSweden Unit of Biostatistics Institute of Environmental MedicineKarolinska InstitutetStockholmSweden Center for Stroke Research Berlin and Department of Neurology Charité-Universitätsmedizin BerlinBerlinGermany Stroke Research Institute of Cardiovascular and Medical SciencesUniversity of GlasgowGlasgowUK International Clinical Research Center and Neurology Department St.Anne's University Hospital in Brno and Masaryk UniversityBrnoCzech Republic Department of Radiology University HospitalHradec KraloveCzech Republic Comprehensive Cerebrovascular Center HospitalČeskéBudějoviceCeske BudejoviceCzech Republic Emergency Department Stroke Unit Department of Neurology and PsychiatryHospital Policlinico Umberto I'Sapienza'UniversityRomeItaly

Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute *** prognostic tool has yet gained any widespread *** compared the predictive value of various models based on National Institutes of Health Stroke Scale(NIHSS)subitems,ranging from simple to more complex models,for predicting large artery occlusion(LAO)in anterior circulation *** Patients registered in the SITS international Stroke Register with available NIHSS and radiological arterial occlusion data were *** compared 2042 patients harbouring an LAO with 2881 patients having no/distal *** binary logistic regression,we developed models ranging from simple 1 NIHSS-subitem to full NIHSS-subitems *** and specificities of the models for predicting LAO were *** The model with highest predictive value included all NIHSS subitems for predicting LAO(area under the curve(AUC)0.77),yielding a sensitivity and specificity of 69%and 76%,*** second most predictive model(AUC 0.76)included 4-NIHSS-subitems(level of consciousness commands,gaze,facial and arm motor function)yielding a sensitivity and specificity of 67%and 75%,*** simplest model included only deficits in arm motor-function(AUC 0.72)for predicting LAO,yielding a sensitivity and specificity of 67%and 72%,*** Although increasingly more complex models yield a higher discriminative performance for predicting LAO,differences between models are not *** grade of arm dysfunction along with an established stroke-diagnosis model may serve as a surrogate measure of arterial occlusion-status,thereby assisting in triage decisions.

关键词： occlusion specificity diagnosis

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