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@article{1650138,
author = {Cooray, C. and Mazya, M.V. and Bottai, M. and Scheitz, J.F. and AbdulandRahim, A.H. and Moreira, T.P. and Mikulík, Robert and Krajina, A. and Nevsimalova, M. and Toni, D. and Wahlgren, N. and Ahmed, N.},
article_location = {LONDON},
article_number = {4},
doi = {http://dx.doi.org/10.1136/svn-2018-000165},
keywords = {thrombolysis; thrombectomy; stroke},
language = {eng},
issn = {2059-8688},
journal = {STROKE AND VASCULAR NEUROLOGY},
title = {Are you suffering from a large arterial occlusion? Please raise your arm!},
url = {https://svn.bmj.com/content/svnbmj/3/4/215.full.pdf},
volume = {3},
year = {2018}
}
TY - JOUR
ID - 1650138
AU - Cooray, C. - Mazya, M.V. - Bottai, M. - Scheitz, J.F. - Abdul-Rahim, A.H. - Moreira, T.P. - Mikulík, Robert - Krajina, A. - Nevsimalova, M. - Toni, D. - Wahlgren, N. - Ahmed, N.
PY - 2018
TI - Are you suffering from a large arterial occlusion? Please raise your arm!
JF - STROKE AND VASCULAR NEUROLOGY
VL - 3
IS - 4
SP - 215-221
EP - 215-221
PB - BMJ PUBLISHING GROUP
SN - 20598688
KW - thrombolysis
KW - thrombectomy
KW - stroke
UR - https://svn.bmj.com/content/svnbmj/3/4/215.full.pdf
L2 - https://svn.bmj.com/content/svnbmj/3/4/215.full.pdf
N2 - Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke. No prognostic tool has yet gained any widespread use. We 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 stroke. Methods Patients registered in the SITS international Stroke Register with available NIHSS and radiological arterial occlusion data were analysed. We compared 2042 patients harbouring an LAO with 2881 patients having no/distal occlusions. Using binary logistic regression, we developed models ranging from simple 1 NIHSS-subitem to full NIHSS-subitems models. Sensitivities and specificities of the models for predicting LAO were examined. Results 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%, respectively. The 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%, respectively. The simplest model included only deficits in arm motor-function (AUC 0.72) for predicting LAO, yielding a sensitivity and specificity of 67% and 72%, respectively. Conclusions Although increasingly more complex models yield a higher discriminative performance for predicting LAO, differences between models are not large. Assessing 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.
ER -
COORAY, C., M.V. MAZYA, M. BOTTAI, J.F. SCHEITZ, A.H. ABDUL-RAHIM, T.P. MOREIRA, Robert MIKULÍK, A. KRAJINA, M. NEVSIMALOVA, D. TONI, N. WAHLGREN a N. AHMED. Are you suffering from a large arterial occlusion? Please raise your arm! \textit{STROKE AND VASCULAR NEUROLOGY}. LONDON: BMJ PUBLISHING GROUP, roč.~3, č.~4, s.~215-221. ISSN~2059-8688. doi:10.1136/svn-2018-000165. 2018.
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