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.
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.
Authors: Ethan S Brandler; Mohit Sharma; Flynn McCullough; David Ben-Eli; Bradley Kaufman; Priyank Khandelwal; Elizabeth Helzner; Richard H Sinert; Steven R Levine Journal: J Stroke Cerebrovasc Dis Date: 2015-07-07 Impact factor: 2.136
Authors: William J Powers; Alejandro A Rabinstein; Teri Ackerson; Opeolu M Adeoye; Nicholas C Bambakidis; Kyra Becker; José Biller; Michael Brown; Bart M Demaerschalk; Brian Hoh; Edward C Jauch; Chelsea S Kidwell; Thabele M Leslie-Mazwi; Bruce Ovbiagele; Phillip A Scott; Kevin N Sheth; Andrew M Southerland; Deborah V Summers; David L Tirschwell Journal: Stroke Date: 2018-01-24 Impact factor: 7.914
Authors: Christopher T Richards; Ryan Huebinger; Katie L Tataris; Joseph M Weber; Laura Eggers; Eddie Markul; Leslee Stein-Spencer; Kenneth S Pearlman; Jane L Holl; Shyam Prabhakaran Journal: Prehosp Emerg Care Date: 2018-01-03 Impact factor: 3.077
Authors: David Pickham; André Valdez; Jelle Demeestere; Robin Lemmens; Linda Diaz; Sherril Hopper; Karen de la Cuesta; Fannie Rackover; Kenneth Miller; Maarten G Lansberg Journal: Prehosp Emerg Care Date: 2018-08-23 Impact factor: 3.077
Authors: Jason T McMullan; Brian Katz; Joseph Broderick; Pamela Schmit; Heidi Sucharew; Opeolu Adeoye Journal: Prehosp Emerg Care Date: 2017-01-25 Impact factor: 3.077
Authors: Heidi Mochari-Greenberger; Ying Xian; Anne S Hellkamp; Phillip J Schulte; Deepak L Bhatt; Gregg C Fonarow; Jeffrey L Saver; Mathew J Reeves; Lee H Schwamm; Eric E Smith Journal: J Am Heart Assoc Date: 2015-08-12 Impact factor: 5.501
Authors: Mehul D Patel; Jackie Thompson; José G Cabañas; Jefferson G Williams; Erin Lewis; Michael Bachman; Mahmoud Al Masry; Charles LaVigne; Leonardo Morantes; Tibor Becske; Omar Kass-Hout Journal: J Neurointerv Surg Date: 2021-04-23 Impact factor: 5.836