Research Paper|Volume 13, Issue 10|pp 13680—13692

Design and validation of a recognition instrument—the stroke aid for emergency scale—to predict large vessel occlusion stroke

Baorui Zhang^1,^2,³, Xiaochuan Huo^1,^2,³, Fei Yuan^1,^2,³, Guangrong Song^1,^2,³, Lang Liu⁴, Gaoting Ma^1,^2,³, Dapeng Mo^1,^2,³, Zhongxue Wu^1,^2,³, Zhongrong Miao^1,^2,³, Aihua Liu^1,^2,³

¹Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
²Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
³China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
⁴Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha 410011, Hunan, China

* Equal contribution

Received: October 6, 2020Accepted: March 23, 2021Published: April 26, 2021

https://doi.org/10.18632/aging.202910

Copyright: © 2021 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background and purpose: Rapidly recognizing patients with large-vessel occlusion stroke (LVOS) and transferring them to a center offering recanalization therapy is crucial of maximizing the benefits of early treatment. We therefore aimed to design an easy-to-use recognition instrument for identifying LVOS.

Methods: Prospective data were collected from emergency departments of 12 stroke-center hospitals in China during a 17-month study period. The Stroke Aid for Emergency (SAFE) scale is based on consciousness commands, facial palsy, gaze, and arm motor ability. Receiver operating characteristic analysis was used to obtain the area under the curve for the SAFE scale and previously established scales to predict LVOS.

Results: The SAFE scale could accurately predict LVOS at an accuracy rate comparable to that of the National Institutes of Health Stroke Scale (c-statistics: 0.823 versus 0.831, p = 0.4798). The sensitivity, specificity, positive predictive value, and negative predictive value for the SAFE scale were 0.6875, 0.8577, 0.6937, and 0.8542, respectively, with a cutoff point of 4. The SAFE scale also performed well in a subgroup analysis based on the patients’ ages, occluded vessel locations, and the onset-to-door times.

Conclusions: The SAFE scale can accurately recognize LVOS at a rate comparable to those of other, similar scales.