ACCURACY OF PREHAST IN TERMS OF DIAGNOSIS OF ACUTE ISCHEMIC STROKE PATIENTS

Background and Aim : Recently, a new scale named as PreHospital Ambulance Stroke Test(PreHAST) has been proposed for both fast identification of stroke and also evaluation of strokeseverity. The purpose of our study is to test accuracy of PreHAST.Methods : This diagnostic accuracy study has been conducted via multicentric manner. Samplingwas performed retrospectively and all patients over the age of 18 presenting to the ED, who hadundergone brain magnetic resonance imaging (MRI) due to suspicion of stroke were included. Alldata were gathered in a pre-prepared checklist consisting of 3 sections. The first section of thechecklist included baseline characteristics and demographic data. The second part includedphysical examination findings related to the 8 items of PreHAST scale. The third part wasdedicated to the final diagnosis based on the interpretation of brain MRI which is considered asthe gold standard method of AIS diagnosis in the current study.Results : A data of 805 patients with the mean age of 67.1±13.6 were analyzed, of whom, 463patients (57.5%) were males. Of all suspected patients, 562 patients (69.8%) had ischemic strokesbased-on the gold standard diagnosis. The ROC analysis showed an AUC of 0.824 (95%CI; 0.80-0.85). In the proposed cut-off point (Score ≥ 1), it showed a sensitivity of 93.2% (95% CI; 90.8-95.2%) and a specificity of 46.5% (95% CI; 40.1-53.0%). Based-on the maximum efficiency, thebest cut-off point was the score of ≥2 with a sensitivity of 87.7% (95% CI; 84.7-90.3%) and aspecificity of 61.3% (95% CI; 54.9-67.5%).Conclusion : We found that the proposed cut-off point (score ≥ 1) has a sensitivity of 93.2% anda specificity of 46.5% in terms of diagnosis of AIS patients.

Keywords:

Decision Support Techniques , Emergency Medical Service , Stroke