Usefulness of a single-parameter tool for the prediction of large vessel occlusion in acute stroke
| Autor: | Bénédicte Fadat, Thibaut Allou, Denis Sablot, Vincent Costalat, Caroline Arquizan, Wael Chaabane, Majo Ibanez, Alain Bonafe, Philippe Smadja, Marlène Lachcar, Franck Leibinger, Alexandre Laverdure, Adrian Dumitrana, Isabelle Mourand, Chawki Jebali, Maxime Tardieu, Laurent Ortega, Adelaïde Ferraro, Ludovic Nguyen Them, Zoubir Mourad Bensalah, Julie Mas, Laurène Van Damme, Jean-Christophe Blenet, Nicolas Gaillard, Snejana Jurici, Gregory Gascou, Geoffroy Farouil, Frederique Damon, Ali Ousji, Sabine Aptel, D. Heve, Anais Dutray, Nadège Olivier |
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| Přispěvatelé: | Centre Hospitalier Saint Jean de Perpignan, Département de neurologie [Montpellier], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Département de Neuroradiologie[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Agence Régionale de Santé Occitanie (ARS Occitanie), Université de Montpellier (UM), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Neurology Stroke management medicine.medical_treatment MESH: Stroke Brain Ischemia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Stroke Aged Neuroradiology Thrombectomy MESH: Aged Palsy MESH: Humans business.industry MESH: Brain Ischemia Thrombolysis medicine.disease Stroke unit MESH: Male MESH: Emergency Service Hospital Pre-hospital triage Cardiology MESH: Emergency Medical Services Female Observational study [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] Neurology (clinical) Triage Emergency Service Hospital business MESH: Female 030217 neurology & neurosurgery MESH: Triage [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology First aid Large vessel occlusion |
| Zdroj: | Journal of Neurology Journal of Neurology, Springer Verlag, 2021, 268 (4), pp.1358-1365. ⟨10.1007/s00415-020-10286-8⟩ |
| ISSN: | 0340-5354 1432-1459 |
| DOI: | 10.1007/s00415-020-10286-8⟩ |
| Popis: | International audience; Background: In acute stroke, large vessel occlusion (LVO) should be promptly identified to guide patient's transportation directly to comprehensive stroke centers (CSC) for mechanical thrombectomy (MT). In many cases, prehospital multi-parameter scores are used by trained emergency teams to identify patients with high probability of LVO. However, in several countries, the first aid organization without intervention of skilled staff precludes the on-site use of such scores. Here, we assessed the accuracy of LVO prediction using a single parameter (i.e. complete hemiplegia) obtained by bystander's telephone-based witnessing.Patients and methods: This observational, single-center study included consecutive patients who underwent intravenous thrombolysis at the primary stroke center and/or were directly transferred to a CSC for MT, from January 1, 2015 to March 1, 2020. We defined two groups: patients with initial hemiplegia (no movement in one arm and leg and facial palsy) and patients without initial hemiplegia, on the basis of a bystander's witnessing.Results: During the study time, 874 patients were included [mean age 73 years (SD 13.8), 56.7% men], 320 with initial hemiplegia and 554 without. The specificity of the hemiplegia criterion to predict LVO was 0.88, but its sensitivity was only 0.53.Conclusion: Our results suggest that the presence of hemiplegia as witnessed by a bystander can predict LVO with high specificity. This single criterion could be used for decision-making about direct transfer to CSC for MT when the absence of emergency skilled staff precludes the patient's on-site assessment, especially in regions distant from a CSC. |
| Databáze: | OpenAIRE |
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