dc.contributor.author
Schlemm, Ludwig
dc.contributor.author
Schlemm, Eckhard
dc.date.accessioned
2018-06-08T10:51:42Z
dc.date.available
2018-03-16T11:14:49.630Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/21224
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-24520
dc.description.abstract
Background: Clinical scales to detect large vessel occlusion (LVO) may help to
determine the optimal transport destination for patients with suspected acute
ischemic stroke (AIS). The clinical benefit associated with improved
diagnostic accuracy of these scales has not been quantified. Methods: We used
a previously reported conditional model to estimate the probability of good
outcome (modified Rankin scale sore ≤2) for patients with AIS and unknown
vessel status occurring in regions with greater proximity to a primary than to
a comprehensive stroke center. Optimal rapid arterial occlusion evaluation
(RACE) scale cutoff scores were calculated based on time-dependent effect-size
estimates from recent randomized controlled trials. Probabilities of good
outcome were compared between a triage strategy based on these cutoffs and a
strategy based on a hypothetical perfect LVO detection tool with 100%
diagnostic accuracy. Results: In our model, the additional benefit of a
perfect LVO detection tool as compared to optimal transport-time dependent
RACE cutoff scores ranges from 0 to 5%. It is largest for patients with medium
stroke symptom severity (RACE score 5) and in geographic environments with
longer transfer time between the primary and comprehensive stroke center.
Conclusion: Based on a probabilistic conditional model, the results of our
simulation indicate that more accurate prehospital clinical LVO detections
scales may be associated with only modest improvements in the expected
probability of good outcome for patients with suspected acute ischemic stroke
and unknown vessel status.
en
dc.format.extent
5 Seiten
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject
Ischemic stroke
en
dc.subject
Endovascular treatment
en
dc.subject
Thrombectomy
en
dc.subject
Thrombolysis
en
dc.subject
Prehospital triage
en
dc.subject
Emergency medical services
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::616 Krankheiten
dc.title
Clinical benefit of improved Prehospital stroke scales to detect stroke patients with large vessel occlusions: results from a conditional probabilistic model
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1186/s12883-018-1021-8
dcterms.bibliographicCitation.journaltitle
BMC Neurology
dcterms.bibliographicCitation.number
16
dcterms.bibliographicCitation.originalpublishername
BMC
dcterms.bibliographicCitation.volume
18
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000029345
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000009547
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
29427993
dcterms.isPartOf.issn
1471-2377