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Predictive value of the Cincinnati Prehospital Stroke Scale for identifying thrombolytic candidates in acute ischemic stroke

Authors
 Je Sung You  ;  Sung Phil Chung  ;  Hyun Soo Chung  ;  Hye Sun Lee  ;  Jong Woo Park  ;  Hyun Jong Kim  ;  Shin Ho Lee  ;  Incheol Park  ;  Hahn Shick Lee 
Citation
 AMERICAN JOURNAL OF EMERGENCY MEDICINE, Vol.31(12) : 1699-1702, 2013 
Journal Title
 AMERICAN JOURNAL OF EMERGENCY MEDICINE 
ISSN
 0735-6757 
Issue Date
2013
MeSH
Aged ; Brain Ischemia/drug therapy* ; Cohort Studies ; Emergency Medical Services/methods ; Female ; Fibrinolytic Agents/therapeutic use* ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Patient Selection* ; Retrospective Studies ; Severity of Illness Index ; Stroke/drug therapy* ; Thrombolytic Therapy/methods* ; Tissue Plasminogen Activator/therapeutic use* ; Treatment Outcome ; Urokinase-Type Plasminogen Activator/therapeutic use*
Keywords
Aged ; Brain Ischemia/drug therapy* ; Cohort Studies ; Emergency Medical Services/methods ; Female ; Fibrinolytic Agents/therapeutic use* ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Patient Selection* ; Retrospective Studies ; Severity of Illness Index ; Stroke/drug therapy* ; Thrombolytic Therapy/methods* ; Tissue Plasminogen Activator/therapeutic use* ; Treatment Outcome ; Urokinase-Type Plasminogen Activator/therapeutic use*
Abstract
BACKGROUND: Despite the usefulness of the Cincinnati Prehospital Stroke Scale (CPSS) for rapid recognition of acute stroke, its ability to assess stroke severity is unclear. We investigated the usefulness of CPSS for assessment of stroke severity by comparing CPSS and National Institutes of Health Stroke Scale (NIHSS) scores in patients who were candidates for thrombolytic therapy at hospital admission within 6 hours of symptom onset. METHODS: We conducted a retrospective analysis of a prospective registry database of consecutive patients included in the brain salvage through emergency stroke therapy program. In the emergency department, CPSS score was determined by emergency medical technicians. A CPSS cut-off score was estimated for candidates of thrombolytic therapy by comparing CPSS and NIHSS scores of patients who actually received thrombolytic therapy. Clinical outcomes were compared among patients with scores near the cut-off. Independent predictors of outcome were evaluated by multivariate logistic regression analysis. RESULTS: Strong correlations were observed between CPSS and NIHSS scores within 3 hours (R = 0.778) and 6 hours (R = 0.769) of symptom onset. The optimal cut-off score was 2 for CPSS was associated with actual usage of intravenous tissue plasminogen activator (odds ratio [OR] 34.455; 95% confidence interval [CI] 7.924-149.817, P < .0001) and actual usage of thrombolytic therapy overall (intravenous tissue plasminogen activator or intra-arterial urokinase) (OR 36.310; 95% CI 10.826-121.782, P < .0001). CONCLUSION: The CPSS is an effective prehospital stroke scale for the determination of stroke severity and identification of candidates for thrombolytic therapy
Full Text
http://www.sciencedirect.com/science/article/pii/S0735675713005366
DOI
10.1016/j.ajem.2013.08.029
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hahn Shick(이한식)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88691
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