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Background The Rapid Arterial oCclusion Evaluation (RACE) score can identify patients with anterior circulation large‐vessel occlusion (aLVO) ischemic stroke for transportation to a comprehensive stroke center for endovascular thrombectomy. However, patients with intracranial hemorrhage (ICH) may also benefit from direct transportation to a comprehensive stroke center for neurosurgical treatment. We aimed to assess if the RACE score can distinguish patients with ICH in addition to aLVO stroke from other patients with suspected stroke. Methods We analyzed data from the LPSS (Leiden Prehospital Stroke Study), a multicenter, prospective, observational cohort study in 2 Dutch ambulance regions. Ambulance paramedics documented prehospital observations in all patients aged ≥18 years with suspected stroke. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of a positive RACE score (≥5 points) for a diagnosis of ICH or aLVO stroke, compared with patients with non‐aLVO stroke, transient ischemic attack, or stroke mimic. In addition, we performed a multivariable logistic regression analysis and calculated adjusted odds ratios (ORs). Results We included 2004 patients with a stroke code, of whom 149 had an ICH, 153 had an aLVO stroke, 687 had a non‐aLVO stroke, 262 had a transient ischemic attack, and 753 had a stroke mimic. Patients with ICH and aLVO stroke more often had a positive RACE score than other patients with suspected stroke (46.2% and 58.0%, respectively, versus 6.4%; P |
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