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KMID : 0385920130240030272
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Journal of the Korean Society of Emergency Medicine
2013 Volume.24 No. 3 p.272 ~ p.278
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Validation of Pre-Hospital Stroke Screens by Ambulance Service Personnel: A Prospective Observation Study
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Ahn Ki-Ok
Shin Sang-Do
Park Chang-Bae
Song Kyoung-Jun
Hong Ki-Jeong
Lee Seung-Chul
Moon Sung-Woo
Cha Won-Chul
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Abstract
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Purpose: We evaluated the validity of Pre-Hospital stroke screening (PHSS) by 119 ambulance rescuers in Korea.
Methods: Patients at least 20 years old with presumed stroke were transported to six emergency medical centers and prospectively enrolled during a 12-month period. A total of 119 ambulance rescuers applied the Cincinnati Pre- Hospital Stroke Scale (CPHSS) and the Los Angeles Pre- Hospital Stroke Screen (LAPHSS). Emergency physicians (EPs) further assessed the patients with CPHSS and LAPHSS. The final diagnoses were divided into stroke and other disease categories through a review of hospital records. The sensitivity and specificity of the two screening tools were analyzed for predicting stroke. The CPHSS and LAPHSS scores from all patients were compared between the 119 ambulance rescuers and EPs.
Results: The 119 ambulance rescuers referred 348 suspected stroke patients, of whom 164(47.1%) had their stroke confirmed. For all kinds of stroke, the sensitivity and specificity of the CPHSS were 86.3%[95% confidence interval (CI) 58.6~76.1] and 65.9%(95% CI 57.0~74.0), respectively, and those of the LAPHSS were 70%(95% CI 61.0~78.0) and 67.8%(95% CI 58.6~76.1), respectively. The Kappa value between the 119 ambulance rescuers and EPs was k=0.619(95% CI 0.523~0.715) for the CPHSS and k=0.392(95% CI 0.275~0.510) for the LAPHSS.
Conclusion: CPHSS and LAPSS performed by 119 ambulance rescuers had considerable validity in Korea.
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KEYWORD
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Prehospital Emergency Care, Stroke, Validity
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