J Korean Soc Emerg Med.  2000 Dec;11(4):525-529.

Adequacy of Siriraj Stroke Score in Differentiation of Stroke Patients

• Yoo BD
• Lee MG
• Seo YJ
• Jo J
• Park CS
• Lee DP

Abstract

BACKGROUND: The differentiation between hemorrhagic(HS) and norhemorrhagic(NHS) stroke is the most important first step in the management of acute stroke because clinical management of the two disorders differs substantially. Neuroimaging studies are useful in diagnosing and distinctioning between HS and NHS. The use of clinical variables, such as Siriraj stroke scores(SSS), has led to good sensitivity, specificity and predictive values. The aim of our study was to evaluate the use of the SSS in the Korean population and assess whether it could aid to expedite treatment decisions.
METHODS
We reviewed 111 cases of stroke patients admitted to our hospital via the emergency department over a 6 months period from July to December 1998. Levels of consciousness, vomiting, headache, and atheroma markers used in the SSS were applied to these patients who met the criteria for a stroke.
RESULTS
Of the 111 patients, the SSS classified 83 with sensitivities of 81.1%(NHS) and 73.3%(HS) and positive predictive values of 84.3% and 68.8%, respectively. The overall accuracy rate was 78.3%.
CONCLUSION
Our results suggest that the SSS is not reliable in distinguishing stroke types in the Korean population. Definite neuroimaging studies are needed prior to thrombolytic therapy.

MeSH Terms

Consciousness
Emergency Service, Hospital
Headache
Humans
Neuroimaging
Plaque, Atherosclerotic
Sensitivity and Specificity
Stroke*
Thrombolytic Therapy
Vomiting