Potential Impact of C-STAT for Prehospital Stroke Triage up to 24 Hours on a Regional Stroke System
In: Prehospital emergency care, Jg. 24 (2019-10-04), Heft 4
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Zugriff:
BACKGROUND AND PURPOSE: Thrombectomy for large vessel occlusion acute ischemic stroke (AIS-LVO) may benefit patients up to 24 hour since last known normal (LKN). Prehospital tools, like the Cincinnati Stroke Triage Assessment Tool (C-STAT), are used to select hospital destination for suspected AIS-LVO patients. The objective of this study was to estimate the potential impact of the expanded thrombectomy time window on suspected AIS-LVO cases transported to the regional comprehensive stroke center (CSC). METHODS: From June to November 2015, C-STAT was performed by prehospital providers following a positive prehospital Cincinnati Prehospital Stroke Scale (CPSS) stroke screen in suspected stroke/TIA patients. There was no preferential triage based on C-STAT results. Final diagnoses, including the presence of AIS-LVO was ascertained via medical record review. Impact of positive C-STAT cases on CSC volumes was estimated for up to 24 hours since LKN. RESULTS: Of 158 patients with prehospital suspicion for stroke/TIA, 105 were CPSS positive within 24 hours of onset and had complete C-STAT and clinical data available for analysis. Forty-six percent (17/37) of C-STAT + were non-strokes. C-STAT sensitivity and specificity for LVO were 71% (95% CI 36–92) and 67% (95% CI 58–80), respectively. C-STAT triage would increase transport of prehospital suspected stroke cases to the CSC by 11% (12/105) within six hours and 21% (22/105) within 24 hours. Of 37 C-STAT + patients, only 5 (13.5%) had LVO as final diagnosis. CONCLUSIONS: Preferential triage of prehospital suspected stroke patients using C-STAT would increase the number of patients transported to the CSC by 11% within six hours and an additional 10% from six to 24 hours. For every patient with LVO as final diagnosis, approximately an additional 6 non-LVO patients would be triaged to a CSC.
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Potential Impact of C-STAT for Prehospital Stroke Triage up to 24 Hours on a Regional Stroke System
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Autor/in / Beteiligte Person: | Sucharew, Heidi ; Schmit, Pamela ; Adeoye, Opeolu ; Broderick, Joseph P. ; McMullan, Jason T. ; James L Li ; Katz, Brian |
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Zeitschrift: | Prehospital emergency care, Jg. 24 (2019-10-04), Heft 4 |
Veröffentlichung: | 2019 |
Medientyp: | unknown |
ISSN: | 1545-0066 (print) |
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