Prehospital stroke scale (FAST PLUS Test) predicts patients
with intracranial large vessel occlusion

J 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

DOI

http://dx.doi.org/10.1002/brb3.1087

UT WoS

000445850000019

Keywords in English

large vessel occlusion stroke; paramedics; triage test

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.

Citovat

VÁCLAVÍK, Daniel, Michal BAR, Lukáš KLEČKA, David HOLEŠ, Martin ČÁBAL and Robert MIKULÍK. Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion. Brain and Behavior. Hoboken: John Wiley and Sons Inc., 2018, vol. 8, No 9, p. 1-7. ISSN 2162-3279. Available from: https://dx.doi.org/10.1002/brb3.1087.

@article{1455718,
   author = {Václavík, Daniel and Bar, Michal and Klečka, Lukáš and Holeš, David and Čábal, Martin and Mikulík, Robert},
   article_location = {Hoboken},
   article_number = {9},
   doi = {http://dx.doi.org/10.1002/brb3.1087},
   keywords = {large vessel occlusion stroke; paramedics; triage test},
   language = {eng},
   issn = {2162-3279},
   journal = {Brain and Behavior},
   title = {Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion},
   volume = {8},
   year = {2018}
}

TY  - JOUR
ID  - 1455718
AU  - Václavík, Daniel - Bar, Michal - Klečka, Lukáš - Holeš, David - Čábal, Martin - Mikulík, Robert
PY  - 2018
TI  - Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion
JF  - Brain and Behavior
VL  - 8
IS  - 9
SP  - 1-7
EP  - 1-7
PB  - John Wiley and Sons Inc.
SN  - 21623279
KW  - large vessel occlusion stroke
KW  - paramedics
KW  - triage test
N2  - 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.
ER  -

VÁCLAVÍK, Daniel, Michal BAR, Lukáš KLEČKA, David HOLEŠ, Martin ČÁBAL and Robert MIKULÍK. Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion. \textit{Brain and Behavior}. Hoboken: John Wiley and Sons Inc., 2018, vol.~8, No~9, p.~1-7. ISSN~2162-3279. Available from: https://dx.doi.org/10.1002/brb3.1087.

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