J Korean Soc Emerg Med.  2013 Jun;24(3):272-278.

Validation of Pre-Hospital Stroke Screens by Ambulance Service Personnel: A Prospective Observation Study

• Ahn KO
• Shin SD
• Park CB
• Song KJ
• Hong KJ
• Lee SC
• Moon S
• Cha WC

Abstract

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.

Keyword

Prehospital Emergency Care; Stroke; Validity

MeSH Terms

Ambulances*
Diagnosis
Emergencies
Emergency Medical Services
Hospital Records
Humans
Korea
Mass Screening
Prospective Studies*
Sensitivity and Specificity
Stroke*