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KMID : 0385920080190010007
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Journal of the Korean Society of Emergency Medicine
2008 Volume.19 No. 1 p.7 ~ p.14
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External Validation of Prehospital Stroke Screen Scales for EMT: One Center Study
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Suh Dong-Bum
Shin Sang-Do
Kim Yu-Jin
Ahn Ki-Ohk
Song Kyoung-Jun
Park Ju-Ok
Jeong Joong-Sik
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Abstract
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Purpose: We evaluated the validity of Cincinnati Prehospital Stroke Scale (CPSS) and the Los Angeles Prehospital Stroke Screen (LAPSS) as prehospital stroke assessment tools for EMT-basics in Korea.
Methods: Patients (age≥15 years) transported to a regional emergency center by 119 ambulances with one of 4 chiefs (altered mental status, weakness, dizziness, and syncope) were prospectively enrolled in the study during a 12-months period. Independent hospital EMT-basics in the emergency department triaged and recorded the LAPSS and the CPSS finding. On the basis of the final diagnosis by a neurologist, the sensitivity and specificity of the two methods were evaluated for all kinds of stroke and acute stroke within six hours of symptom onset.
Results: The study collected data for 653 patients. 47.2% of patients were male, with an average age of 62.2±15.3 years old. Their chief complaints were altered mental status (55.4%), weakness (9.3%), dizziness (16.7%), and syncope
(18.5%). Of 89 stroke patients, 51.7% were diagnosed with ischemic stroke, 32.6% with hemorrhagic stroke, 15.7%
with transient ischemic attack, and 6.9% with acute stroke. For all strokes, sensitivity and specificity of the LAPSS were
21.3% and 95.7%, and those of the CPSS were 44.9% and 80.7%, respectively. For acute stroke, sensitivity and specificity
of the LAPSS were 22.2% and 94.6%, and those of the CPSS were 48.9% and 79.1%.
Conclusion: US prehospital stroke assessment tools had low sensitivity in the hands of Korean EMT-basics in one
regional emergency medical center. For improving prehospital diagnosis of stroke in Korean EMS, we should recommend
the development of additional assessment tools.
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KEYWORD
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Prehospital Emergency Care, Stroke, Validity
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