| Title: |
Prehospital scale to differentiate intracerebral hemorrhage from large-vessel occlusion patients: A prospective cohort study |
| Authors: |
Freixa-Cruz, A.; Jimenez-Jimenez, G.; Mauri-Capdevila, Gerard; Gallego-Sánchez, Y.; García-Díaz, A.; Mitjana-Penella, R.; Paul-Arias, M.; Pereira-Priego, C.; Ruiz-Fernández, E.; Salvany-Montserrat, S.; Sancho-Saldaña, A.; San-Pedro-Murillo, E.; Saureu, E.; Vázquez-Justes, D.; Purroy, Francisco |
| Publisher Information: |
Springer Science and Business Media LLC |
| Publication Year: |
2024 |
| Description: |
Background Evaluating scales to detect large vessel occlusion (LVO) could aid in considering early referrals to a thrombectomy-capable center in the prehospital stroke code setting. Nevertheless, they entail a significant number of false positives, corresponding to intracranial hemorrhages (ICH). Our study aims to identify easily collectible variables for the development of a scale to differentiate patients with ICH from LVO. Methods We conducted a prospective cohort study of stroke code patients between May 2021 and January 2023. Patients were evaluated with CT/CT-Angiography at arrival. We compared clinical variables and vascular risk factors between ICH and LVO patients. Results Out of 989 stroke code patients, we included 190 (66.7%) LVO cases and 95 (33.3) ICH cases. In the multivariate analysis, headache (odds ratio [OR] 3.56; 1.50–8.43), GCS < 8 (OR 8.19; 3.17–21.13), SBP > 160mmHg (OR 6.43; 3.37–12.26) and male sex (OR 2.07; 1.13–3.80) were associated with ICH, while previous hypercholesterolemia (OR 0.35; 0.19–0.65) with LVO. The scale design was conducted, assigning a score to each significant variable based on its specific weight: +2 points for SBP > 160, + 1 points for headache, + 1 points for male sex, + 2 points for GCS < 8, and − 1 points for HCL. The area under the curve was 0.82 (0.77–0.87). A score ≥ 4 exhibited a sensitivity of 0.10, a specificity of 0.99, a positive predictive value of 0.21, and a negative predictive value of 0.98 . Conclusion We present the development of a prehospital scale to discriminate between ICH and LVO patients, utilizing easily detectable variables in the prehospital setting. |
| Document Type: |
other/unknown material |
| Language: |
unknown |
| DOI: |
10.21203/rs.3.rs-4623877/v1 |
| Availability: |
https://doi.org/10.21203/rs.3.rs-4623877/v1; https://www.researchsquare.com/article/rs-4623877/v1; https://www.researchsquare.com/article/rs-4623877/v1.html |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.57B009C0 |
| Database: |
BASE |