Accuracy of two scores in the diagnosis of stroke subtype in a multicenter cohort study

Annals of Emergency Medicine
Semir NouiraHabib Gamra

Abstract

The distinction between hemorrhagic and ischemic stroke has critical implications for management. For that purpose, clinical scores have been proposed to be used in areas with limited health care resources where brain computed tomographic (CT) scan is not readily available. We conducted this study to evaluate the predictive value of the Allen and Siriraj scores in the differential diagnosis of stroke subtypes. We prospectively collected data for 4 years on the clinical characteristics of patients with stroke in a multicenter study. For all patients, we calculated the Allen and the Siriraj scores and we assessed their accuracy in predicting stroke subtypes with receiver operating characteristics (ROC) curves. We assessed 1,023 patients. Of these, 82.7% (n=846) had ischemic stroke. The area under the ROC curve was higher for Siriraj score compared with the Allen score (0.780 versus 0.702; P=.04). Using the original cutoff points, Siriraj score has a sensitivity for the diagnosis of hemorrhage of 60% and a specificity of 95%; the corresponding values for the Allen score are 55% and 70%, respectively. The negative predictive value was higher for Siriraj score compared to the Allen score (90% versus 80%). The diagnosis of stroke sub...Continue Reading

References

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Citations

Jun 22, 2013·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·E E Philip-EphraimR P Ephraim
Aug 1, 2013·Stroke; a Journal of Cerebral Circulation·Alberto MainoUNKNOWN LiLAC Study Group
Oct 17, 2019·The New England Journal of Medicine·Shaheen ChowdhuryYogesh Jain

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