Evaluating Prehospital Stroke Scales for Large Vessel Occlusion

作者：Noah Nawabi, Esteban Rivera Rivera, Daniel de Wilde, John L. Kilgallon, David I. Nawabi, Varun Bhave, Patrick Emedom-Nnamdi, Ari D. Kappel, Shivani D. Rangwala, Rodolfo E. Alcedo Guardia, Juan Vicenty-Padilla, Saef Izzy, Nirav Patel, Rose Du, Adam A. Dmytriw, Toby Gropen, David S. Liebeskind, Edoardo Gaude, Alfred P. See, Aziz-Sultan MA, Joshua D. Bernstock · 发表于：Neurology · 年份：2026 · DOI：10.1212/wnl.0000000000214484 · 被引用次数：3 · 研究领域：Acute Ischemic Stroke Management、Central Venous Catheters and Hemodialysis、Traumatic Brain Injury and Neurovascular Disturbances

BACKGROUND AND OBJECTIVES: Ischemic stroke remains a leading cause of death and disability worldwide, with large vessel occlusion (LVO) accounting for a disproportionate share of poststroke morbidity. Early identification of LVO is essential for timely intervention with endovascular thrombectomy; however, the clinical scales currently used for triage vary widely in their application and accuracy. This study assesses the diagnostic performance of clinical stroke scales in predicting LVO. METHODS: A systematic review was conducted to identify studies evaluating the diagnostic accuracy of prehospital stroke scales for detecting LVO. Pooled sensitivity and specificity were estimated using a bivariate random-effects model, with diagnostic performance further assessed through summary receiver operating characteristic (ROC) curves and area under the curve (AUC) analysis. A Bayesian network meta-analysis was conducted to rank the scales using surface under the cumulative ranking (SUCRA) probabilities, and post hoc analyses were performed to evaluate publication bias. RESULTS: A total of 58 studies comprising 58,381 patients and 33 unique stroke scales were included in the final analysis. The studies, published between 2014 and 2023, were primarily conducted in North America (50%) and Europe (26%), with a median sample size of 473 participants. Pooled sensitivity ranged from 0.30 (HEMIPARESIS) to 0.99 (LARIO) while specificity varied from 0.34 (FANG) to 0.94 (HEMIPLEGIA). Among the hi...