Detailed Information on Publication Record
2018
Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion
VÁCLAVÍK, Daniel, Michal BAR, Lukáš KLEČKA, David HOLEŠ, Martin ČÁBAL et. al.Basic information
Original name
Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion
Authors
VÁCLAVÍK, Daniel (203 Czech Republic), Michal BAR (203 Czech Republic, guarantor), Lukáš KLEČKA (203 Czech Republic), David HOLEŠ (203 Czech Republic), Martin ČÁBAL (203 Czech Republic) and Robert MIKULÍK (203 Czech Republic, belonging to the institution)
Edition
Brain and Behavior, Hoboken, John Wiley and Sons Inc. 2018, 2162-3279
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30103 Neurosciences
Country of publisher
United States of America
Confidentiality degree
není předmětem státního či obchodního tajemství
Impact factor
Impact factor: 2.072
RIV identification code
RIV/00216224:14110/18:00104208
Organization unit
Faculty of Medicine
UT WoS
000445850000019
Keywords in English
large vessel occlusion stroke; paramedics; triage test
Tags
International impact, Reviewed
Změněno: 10/2/2019 17:47, Soňa Böhmová
Abstract
V originále
Background and Purpose: Mechanical thrombectomy (MT) is indicated for the treatment of large vessel occlusion (LVO) stroke. MT should be provided as quickly as possible; therefore, a test identifying suspected LVO in the prehospitalization stage is needed to ensure direct transport to a comprehensive stroke center (CSC). We assume that patients with clinically severe hemiparesis have a high probability of LVO stroke. We modified the FAST test into the FAST PLUS test: The first part is the FAST test and the second part evaluates the presence of severe arm or leg motor deficit. This prospective multicenter study evaluates the specificity and sensitivity of the FAST PLUS test in detecting LVO stroke. Methods: Paramedics were trained through e-learning to conduct the FAST PLUS test. All prehospital suspected stroke patients who were administered the FAST PLUS test were included. Demographics, National Institutes of Health Stroke Scale (NIHSS) score, brain computed tomography (CT), and CT angiography (CTA) were recorded. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating curve (ROC) area for LVO were calculated. Results: The study included 435 patients. LVO were found in 124 patients (28%). Sensitivity was 93%, specificity was 47%, PPV was 41%, NPV was 94%, and ROC area for ICA/MCA occlusion was 0.65. Intracerebral hemorrhage (ICH) was identified in 48 patients (11%). Conclusion: We found that the FAST PLUS test had a high sensitivity for LVO stroke. Of the 435 patients, 41% were all directly transported to a CSC based on positive FAST PLUS test scores and were potential candidates for MT.