Accuracy of Field Assessment Stroke Triage for Emergency Destination for Diagnosis of Acute Ischemic Stroke Patients

• Main Authors: Mohammad Nasr-Esfahani, Farhad Heydari, Elham Izadi-Dastgerdi, Azade Fereidouni Golsefidi, Pegah Noorshargh
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2021-06-01
• Series: Eurasian Journal of Emergency Medicine
• Subjects: stroke; triage; acute cerebral ischemia; clinical prediction rules; emergency care
• Online Access: http://akademikaciltip.com/archives/archive-detail/article-preview/accuracy-of-field-assessment-stroke-triage-for-eme/47476
• ISSN: 2149-5807; 2149-6048

Aim:Acute stroke is one of the most common and debilitating diseases. Rapid diagnostic measures undertaken upon hospital admission and reduction of the treatment duration will increase access to treatment. The purpose of this study is to examine the accuracy of Field Assessment Stroke Triage for Emergency Destination (FAST-ED) in terms of stroke diagnosis.Materials and Methods:This prospective diagnostic accuracy study was conducted between March 2019 and January 2020. All adult patients transferred to the ED and suspected of having an acute ischemic stroke who had undergone brain magnetic resonance imaging (MRI) were eligible for inclusion. After data collection, receiver operating characteristic curve analysis was performed, and sensitivity, specificity, positive predictive value, and negative predictive value of FAST-ED were calculated and compared with those of the National Institute of Health Stroke Scale (NIHSS) scale.Results:A total of 314 patients who had received MRI within the first 24 hours of symptom onset were included in this study. The mean age was 67.95±13.11 years, and 184 patients (58.60%) were male. Of all patients with suspicion of ischemic stroke, 274 (87.26%) were diagnosed on the basis of the gold standard. The best predictor of stroke in FAST-ED, with a sensitivity of 0.880 and specificity of 0.575, was a cut-off point of 2 (area under the curve: 0.836). The distribution of all FAST-ED symptoms was significant in the stroke and non-stroke groups, with the exception of “Eye deviation.”Conclusion:The FAST-ED scale is relatively simple and has a comparable ability to recognize AIS to that of the more complex NIHSS.