Document Type: Short Communication
Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
Background: Andsberg et al. have recently introduced a novel scoring system entitled “PreHospital Ambulance Stroke Test (PreHAST)”, which helps to early identification of patients with acute ischemic stroke (AIS) even in prehospital setting. Its validity has not been assessed in a study yet, and the purpose of this study was to assess this scoring system on a larger scale to provide further evidence in this regard.
Methods: This was a cross-sectional multi-center accuracy study, in which, sampling was performed prospectively. All patients over 18 years of age admitted to the emergency department (ED) and suspected as AIS cases were included. All required data were recorded in a form consisting of 3 parts: baseline characteristics, neurological examination findings required for calculating PreHAST score, and the ultimate diagnosis made from interpretation of their brain magnetic resonance imaging (MRI).
Results: Data from 805 patients (57.5% men) with the mean age of 67.1 ± 13.6 years were analyzed. Of all the patients presenting with suspected AIS, 562 (69.8%) had AIS based on their MRI findings. At the suggested cut-off point (score ≥ 1), PreHAST had a specificity of 46.5% [95% confidence interval (CI): 40.1%-53.0%) and a sensitivity of 93.2% (95% CI: 90.8%-95.2%).
Conclusion: According to the findings of our study, at the suggested cut-off point (score ≥ 1), PreHAST had 93.2% sensitivity and 46.5% specificity in detection of patients with AIS, which were somewhat different from those reported in the original study, where 100% sensitivity and 40% specificity were reported for this scoring system.
- Baratloo A, Rahimpour L, Abushouk AI, Safari S, Lee CW, Abdalvand A. Effects of telestroke on thrombolysis times and outcomes: A meta-analysis. Prehosp Emerg Care 2018; 22(4): 472-84.
- Saberian P, Tavakoli N, Hasani-Sharamin P, Aghili M, Baratloo A. Accuracy of stroke diagnosis using FAST (Face, Arm, Speech, Time) Tool by emergency medical service dispatchers and technicians and its impact on transport time. Arch Neurosci. 2020; 7(1): e98691.
- Baratloo A, Forouzanfar Mm, Hashemi B, Saeed S, Kasmaei H, Rouhipour A, et al. Tissue plasminogen activator: A literature review. Arch Neurol 2016; 3(1): 30452.
- Brandler ES, Sharma M, Sinert RH, Levine SR. Prehospital stroke scales in urban environments: a systematic review. Neurology 2014; 82(24): 2241-9.
- Andsberg G, Esbjornsson M, Olofsson A, Lindgren A, Norrving B, von EM. PreHospital Ambulance Stroke Test - pilot study of a novel stroke test. Scand J Trauma Resusc Emerg Med 2017; 25(1): 37.
- Karimi S, Motamed H, Aliniagerdroudbari E, Babaniamansour S, Jami A, Baratloo A. The Prehospital Ambulance Stroke Test vs. the Cincinnati Prehospital Stroke Scale: A diagnostic accuracy study. Australas J Paramedicine 2020; 17: 1-7.
- Saberian P, Rafiemanesh H, Heydari F, Mirbaha S, Karimi S, Baratloo A. A multi-center diagnostic accuracy study on nine Prehospital Stroke Screening Scales. Research Square 2020. [Preprint].