Predictive Value of the Prehospital RACE Scale for Large Vessel Occlusion in Acute Stroke Patients.
| Title: | Predictive Value of the Prehospital RACE Scale for Large Vessel Occlusion in Acute Stroke Patients. |
|---|---|
| Authors: | Truong ATL; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Department of Neurology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.; Tran HTM; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Department of Neurology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.; Phan LD; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Nguyen HBT; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Nguyen TQ; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Le TVS; Department of Neurointervention, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Chiem DN; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Nguyen H; Faculty of Medicine, University of Debrecen, Debrecen, Hungary.; Nguyen TN; Department of Neurology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA.; Nguyen TH; Department of Cerebrovascular Disease, People's 115 Hospital, Ho Chi Minh City, Vietnam.; Department of Neurology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam. |
| Source: | Cerebrovascular diseases extra [Cerebrovasc Dis Extra] 2025; Vol. 15 (1), pp. 39-47. Date of Electronic Publication: 2024 Dec 24. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Karger Country of Publication: Switzerland NLM ID: 101577885 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1664-5456 (Electronic) Linking ISSN: 16645456 NLM ISO Abbreviation: Cerebrovasc Dis Extra Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Basel : Karger, 2011- |
| MeSH Terms: | Ischemic Stroke*/physiopathology ; Ischemic Stroke*/therapy ; Ischemic Stroke*/diagnosis ; Ischemic Stroke*/diagnostic imaging ; Emergency Medical Services* ; Decision Support Techniques*; Humans ; Male ; Female ; Prospective Studies ; Predictive Value of Tests ; Aged ; Middle Aged ; Vietnam ; Reproducibility of Results ; Time Factors ; Aged, 80 and over ; Functional Status |
| Abstract: | Introduction: Prehospital stroke scales have been developed to identify anterior large vessel occlusion (LVO) in acute ischemic stroke (AIS) patients for direct transport to thrombectomy-capable hospitals. However, its performance in a Vietnamese population remains unknown. We aimed to evaluate the predictive value of the Rapid Arterial oCclusion Evaluation (RACE) scale for LVO detection in patients with ischemic stroke presenting within 24 h in Vietnam.; Methods: This was a prospective study of patients with AIS admitted at People's 115 Hospital between May 2022 and October 2022. All patients were assessed with the RACE scale with five items: facial palsy (scored 0-2), arm motor function (0-2), leg motor function (0-2), gaze (0-1), and aphasia or agnosia (0-2). LVO was diagnosed by CTA or MRA. Receiver operating characteristic curve, sensitivity, specificity, and accuracy of the RACE scale were analyzed to evaluate its predictive value for LVO.; Results: There were 318 patients included. LVO was detected in 121/318 patients (37.6%). The higher the RACE score, the higher the proportion of patients with LVO (p < 0.001). Receiver operating characteristic curves showed capacity to predict LVO of the RACE scale with an area under the curve (AUC) of 0.767. The optimal RACE cutoff was ≥5 with sensitivity = 0.68, specificity = 0.79, positive predictive value = 0.67, negative predictive value = 0.80, and overall accuracy = 0.75. RACE ≥5 had higher sensitivity and same specificity for detecting LVO in AIS patients within 6-h versus 6-24-h window (AUC = 0.79 vs. 0.75, sensitivity = 0.74 vs. 0.65, specificity = 0.79 vs. 0.80, accuracy = 0.77 vs. 0.74).; Conclusions: The RACE scale is a simple tool that can accurately identify AIS patients with LVO. This tool may be useful for early detection of LVO patients and should be validated in the prehospital setting in Vietnam.; (© 2024 The Author(s). Published by S. Karger AG, Basel.) |
| References: | N Engl J Med. 2018 Feb 22;378(8):708-718. (PMID: 29364767); Int J Stroke. 2024 Mar;19(3):305-313. (PMID: 37807200); Stroke. 2014 Jan;45(1):87-91. (PMID: 24281224); Acad Emerg Med. 1996 Sep;3(9):895-900. (PMID: 8870764); JAMA Neurol. 2016 Feb;73(2):190-6. (PMID: 26716735); J Neurointerv Surg. 2019 Mar;11(3):241-245. (PMID: 30415226); Stroke. 2017 Feb;48(2):290-297. (PMID: 28087804); Stroke. 2016 May;47(5):1381-4. (PMID: 27032445); Stroke. 2016 Aug;47(8):1997-2002. (PMID: 27364531); Lancet. 2016 Apr 23;387(10029):1723-31. (PMID: 26898852); Biometrics. 1988 Sep;44(3):837-45. (PMID: 3203132); Prehosp Emerg Care. 2019 Sep-Oct;23(5):612-618. (PMID: 30668202); Neurology. 2024 May 28;102(10):e209324. (PMID: 38709999); Stroke. 2018 Mar;49(3):e111-e122. (PMID: 29367333); Int J Stroke. 2015 Aug;10(6):822-9. (PMID: 25588617); Epidemiology. 2007 Nov;18(6):805-35. (PMID: 18049195); Lancet Neurol. 2014 Jun;13(6):567-74. (PMID: 24784550); Stroke. 2016 Jul;47(7):1772-6. (PMID: 27272487); JAMA Neurol. 2023 Oct 1;80(10):1028-1036. (PMID: 37603325); Lancet Neurol. 2021 Mar;20(3):213-221. (PMID: 33422191); Lancet. 2023 Apr 22;401(10385):1371-1380. (PMID: 37003289); J Neurointerv Surg. 2019 Aug;11(8):751-756. (PMID: 30580284); N Engl J Med. 2018 Jan 4;378(1):11-21. (PMID: 29129157) |
| Contributed Indexing: | Keywords: Acute ischemic stroke; Large vessel occlusion; Prehospital stroke scales; RACE scale |
| Entry Date(s): | Date Created: 20241224 Date Completed: 20250429 Latest Revision: 20250519 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11842085 |
| DOI: | 10.1159/000543260 |
| PMID: | 39719132 |
| Database: | MEDLINE |
Journal Article