External Validation of the Cincinnati Prehospital Stroke Severity Scale

被引：20

作者：

Kummer, Benjamin R. ^{[1
]}

Gialdini, Gino ^{[2
]}

Sevush, Jennifer L. ^{[1
]}

Kamel, Hooman ^{[1
,2
]}

Patsalides, Athos ^{[3
]}

Navi, Babak B. ^{[1
,2
]}

机构：

[1] Weill Cornell Med Coll, Dept Neurol, 525 East 68th St,Room F610, New York, NY 10065 USA

[2] Weill Cornell Med Coll, Feil Family Brain & Mind Res Inst, New York, NY 10065 USA

[3] Weill Cornell Med Coll, Dept Neurosurg, New York, NY 10065 USA

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2016年 / 25卷 / 05期

基金：

美国国家卫生研究院;

关键词：

Stroke; ischemic stroke; large-vessel occlusion; clinical prediction score; cerebral infarction; acute stroke therapy; ACUTE ISCHEMIC-STROKE; INTRAVENOUS T-PA; ENDOVASCULAR THERAPY; RANDOMIZED-TRIAL; OCCLUSION; DESIGN; VS;

D O I：

10.1016/j.jstrokecerebrovasdis.2016.02.015

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background: The Cincinnati Prehospital Stroke Severity Scale (CPSSS) was recently developed to predict large-vessel occlusions (LVOs) in patients with acute ischemic stroke (AIS). In its derivation study, which consisted of patients enrolled in thrombolysis and endovascular therapy trials, the CPSSS had excellent discriminatory performance. We sought to externally validate the CPSSS in an independent cohort. Methods: Using our institution's prospective stroke registry, we calculated CPSSS scores for all patients diagnosed with AIS at Weill Cornell Medical Center in 2013 and 2014. The primary outcome was presence of LVO and the secondary outcome was a National Institutes of Health Stroke Scale (NIHSS) score of 15 or higher. Harrell's c-statistic was calculated to determine the CPSSS score's discriminatory performance. Using the previously defined cut-point of 2 or higher (range 0-4), we evaluated the test properties of the CPSSS for predicting study outcomes. Results: Among 751 patients with AIS, 664 had vessel imaging and were included in the final analysis. Of these patients, 80 (14.2%) had LVOs and 117 (17.6%) had an NIHSS score of 15 or higher. The median CPSSS score was 0 (interquartile range 0-1) and 133 patients (20%) had scores of 2 or higher. c-statistic was.85 (95% confidence interval [CI].81-.90) for predicting LVO and.94 (95% CI.92-.97) for predicting an NIHSS score of 15 or higher. Using a cut-point of 2 or higher, the CPSSS was 70.0% sensitive and 86.8% specific for predicting LVO, and 87.2% sensitive and 94.3% specific for predicting an NIHSS score of 15 or higher. Conclusions: In a cohort of patients with AIS treated at a tertiary-care stroke center, the CPSSS had reasonable sensitivity and specificity for predicting LVO and severe stroke. Future studies should aim to prospectively validate the score in emergency responders. (C) 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

引用

页码：1270 / 1274

页数：5

共 10 条

[1] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[2] Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke [J].

Broderick, Joseph P. ;

Palesch, Yuko Y. ;

Demchuk, Andrew M. ;

Yeatts, Sharon D. ;

Khatri, Pooja ;

Hill, Michael D. ;

Jauch, Edward C. ;

Jovin, Tudor G. ;

Yan, Bernard ;

Silver, Frank L. ;

von Kummer, Ruediger ;

Molina, Carlos A. ;

Demaerschalk, Bart M. ;

Budzik, Ronald ;

Clark, Wayne M. ;

Zaidat, Osama O. ;

Malisch, Tim W. ;

Goyal, Mayank ;

Schonewille, Wouter J. ;

Mazighi, Mikael ;

Engelter, Stefan T. ;

Anderson, Craig ;

Spilker, Judith ;

Carrozzella, Janice ;

Ryckborst, Karla J. ;

Janis, L. Scott ;

Martin, Renee H. ;

Foster, Lydia D. ;

Tomsick, Thomas A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2013, 368 (10) :893-903

[3] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J].

Campbell, B. C. V. ;

Mitchell, P. J. ;

Kleinig, T. J. ;

Dewey, H. M. ;

Churilov, L. ;

Yassi, N. ;

Yan, B. ;

Dowling, R. J. ;

Parsons, M. W. ;

Oxley, T. J. ;

Wu, T. Y. ;

Brooks, M. ;

Simpson, M. A. ;

Miteff, F. ;

Levi, C. R. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Priglinger, M. ;

Ang, T. ;

Scroop, R. ;

Barber, P. A. ;

McGuinness, B. ;

Wijeratne, T. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Bladin, C. F. ;

Badve, M. ;

Rice, H. ;

de Villiers, L. ;

Ma, H. ;

Desmond, P. M. ;

Donnan, G. A. ;

Davis, S. M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1009-1018

[4] Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke [J].

Goyal, M. ;

Demchuk, A. M. ;

Menon, B. K. ;

Eesa, M. ;

Rempel, J. L. ;

Thornton, J. ;

Roy, D. ;

Jovin, T. G. ;

Willinsky, R. A. ;

Sapkota, B. L. ;

Dowlatshahi, D. ;

Frei, D. F. ;

Kamal, N. R. ;

Montanera, W. J. ;

Poppe, A. Y. ;

Ryckborst, K. J. ;

Silver, F. L. ;

Shuaib, A. ;

Tampieri, D. ;

Williams, D. ;

Bang, O. Y. ;

Baxter, B. W. ;

Burns, P. A. ;

Choe, H. ;

Heo, J. -H. ;

Holmstedt, C. A. ;

Jankowitz, B. ;

Kelly, M. ;

Linares, G. ;

Mandzia, J. L. ;

Shankar, J. ;

Sohn, S. -I. ;

Swartz, R. H. ;

Barber, P. A. ;

Coutts, S. B. ;

Smith, E. E. ;

Morrish, W. F. ;

Weill, A. ;

Subramaniam, S. ;

Mitha, A. P. ;

Wong, J. H. ;

Lowerison, M. W. ;

Sajobi, T. T. ;

Hill, M. D. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1019-1030

[5] Design and Validation of a Prehospital Scale to Predict Stroke Severity Cincinnati Prehospital Stroke Severity Scale [J].

Katz, Brian S. ;

McMullan, Jason T. ;

Sucharew, Heidi ;

Adeoye, Opeolu ;

Broderick, Joseph P. .

STROKE, 2015, 46 (06) :1508-1512

[6] TISSUE-PLASMINOGEN ACTIVATOR FOR ACUTE ISCHEMIC STROKE [J].

MARLER, JR ;

BROTT, T ;

BRODERICK, J ;

KOTHARI, R ;

ODONOGHUE, M ;

BARSAN, W ;

TOMSICK, T ;

SPILKER, J ;

MILLER, R ;

SAUERBECK, L ;

JARRELL, J ;

KELLY, J ;

PERKINS, T ;

MCDONALD, T ;

RORICK, M ;

HICKEY, C ;

ARMITAGE, J ;

PERRY, C ;

THALINGER, K ;

RHUDE, R ;

SCHILL, J ;

BECKER, PS ;

HEATH, RS ;

ADAMS, D ;

REED, R ;

KLEI, M ;

HUGHES, S ;

ANTHONY, J ;

BAUDENDISTEL, D ;

ZADICOFF, C ;

RYMER, M ;

BETTINGER, I ;

LAUBINGER, P ;

SCHMERLER, M ;

MEIROSE, G ;

LYDEN, P ;

RAPP, K ;

BABCOCK, T ;

DAUM, P ;

PERSONA, D ;

BRODY, M ;

JACKSON, C ;

LEWIS, S ;

LISS, J ;

MAHDAVI, Z ;

ROTHROCK, J ;

TOM, T ;

ZWEIFLER, R ;

DUNFORD, J ;

ZIVIN, J .

NEW ENGLAND JOURNAL OF MEDICINE, 1995, 333 (24) :1581-1587

[7] REVASCAT: a randomized trial of revascularization with SOLITAIRE FR® device vs. best medical therapy in the treatment of acute stroke due to anterior circulation large vessel occlusion presenting within eight-hours of symptom onset [J].

Molina, Carlos A. ;

Chamorro, Angel ;

Rovira, Alex ;

de Miquel, Angeles ;

Serena, Joaquin ;

San Roman, Luis ;

Jovin, Tudor G. ;

Davalos, Antoni ;

Cobo, Erik .

INTERNATIONAL JOURNAL OF STROKE, 2015, 10 (04) :619-626

[8] Design and Validation of a Prehospital Stroke Scale to Predict Large Arterial Occlusion The Rapid Arterial Occlusion Evaluation Scale [J].

Perez de la Ossa, Natalia ;

Carrera, David ;

Gorchs, Montse ;

Querol, Marisol ;

Millan, Monica ;

Gomis, Meritxell ;

Dorado, Laura ;

Lopez-Cancio, Elena ;

Hernandez-Perez, Maria ;

Chicharro, Vicente ;

Escalada, Xavier ;

Jimenez, Xavier ;

Davalos, Antoni .

STROKE, 2014, 45 (01) :87-91

[9] Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke [J].

Saver, Jeffrey L. ;

Goyal, Mayank ;

Bonafe, Alain ;

Diener, Hans-Christoph ;

Levy, Elad I. ;

Pereira, Vitor M. ;

Albers, Gregory W. ;

Cognard, Christophe ;

Cohen, David J. ;

Hacke, Werner ;

Jansen, Olav ;

Jovin, Tudor G. ;

Mattle, Heinrich P. ;

Nogueira, Raul G. ;

Siddiqui, Adnan H. ;

Yavagal, Dileep R. ;

Baxter, Blaise W. ;

Devlin, Thomas G. ;

Lopes, Demetrius K. ;

Reddy, Vivek K. ;

de Rochemont, Richard du Mesnil ;

Singer, Oliver C. ;

Jahan, Reza .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (24) :2285-2295

[10] A simple 3-item stroke scale - Comparison with the National Institutes of Health Stroke Scale and prediction of middle cerebral artery occlusion [J].

Singer, OC ;

Dvorak, F ;

de Rochemont, RD ;

Lanfermann, H ;

Sitzer, M ;

Neumann-Haefelin, T .

STROKE, 2005, 36 (04) :773-776

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