Stroke Network of Wisconsin (SNOW) Scale Predicts Large Vessel Occlusion Stroke in the Prehospital Setting.

Autor:	Panichpisal K; Aurora Neuroscience Innovation Institute, Advocate Aurora Health, Milwaukee, WI., Erpenbeck S; University of Pittsburgh School of Medicine, Pittsburgh, PA., Vilar P; Aurora Neuroscience Innovation Institute, Advocate Aurora Health, Milwaukee, WI., Babygirija RP; University of Wisconsin-Madison, Madison, WI., Singh M; Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI.; Marquette University, Milwaukee, WI., Colella MR; Milwaukee County Office of Emergency Management, Milwaukee, WI., Rovin RA; Aurora Neuroscience Innovation Institute, Advocate Aurora Health, Milwaukee, WI.
Jazyk:	angličtina
Zdroj:	Journal of patient-centered research and reviews [J Patient Cent Res Rev] 2022 Apr 18; Vol. 9 (2), pp. 108-116. Date of Electronic Publication: 2022 Apr 18 (Print Publication: 2022).
DOI:	10.17294/2330-0698.1892
Abstrakt:	Purpose: In previous trials, the Stroke Network of Wisconsin (SNOW) scale accurately predicted large vessel occlusion (LVO) stroke in the hospital setting. This study evaluated SNOW scale performance in the prehospital setting and its ability to predict LVO or distal medium vessel occlusion (DMVO) in patients suspected of having acute ischemic stroke (AIS), a scenario in which transport time to an endovascular treatment-capable facility (ECSC) is critical. Methods: All potential AIS patients with last-known-well time of ≤24 hours were assessed by Milwaukee County Emergency Medical Services for LVO using SNOW. Patients with a positive SNOW score were transferred to the nearest ECSC. One such facility, Aurora St. Luke's Medical Center (ASLMC), was the source of all patient data analyzed in this study. LVO was defined as occlusion of the intracranial carotid artery, middle cerebral artery (M1) segment, or basilar artery. Results: From March 2018 to February 2019, 345 AIS-suspected patients were transported to ASLMC; 19 patients were excluded because no vascular imaging was performed. Of 326 patients, 32 had confirmed LVO and 21 DMVO. For identifying LVO, SNOW scale sensitivity was 0.88, specificity 0.40, positive predictive value (PPV) 0.14, negative predictive value (NPV) 0.97, and area under the curve (AUC) 0.64. Ability to predict DMVO was similar. Overall, the SNOW scale showed sensitivity of 0.83, specificity of 0.39, PPV of 0.10, NPV of 0.97, and AUC of 0.60 in identifying candidates for endovascular thrombectomy. Conclusions: In a prehospital setting, the SNOW scale has high sensitivity in identifying candidates for endovascular thrombectomy and proved highly reliable in ruling out stroke due to LVO. Competing Interests: Conflicts of Interest None. (© 2022 Aurora Health Care, Inc.)
Databáze:	MEDLINE
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