洛杉矶院前卒中筛查量表对脑卒中评估的价值

Value of Los Angeles Pre-hospital Stroke Screen in the diagnosis of pre-hospital stroke

摘要:

目的 研究洛杉矶院前卒中筛查量表（LAPSS）对院前脑卒中评估的价值。方法 入组病例选择院前接诊的以神经系统局灶症状或体征为主要表现的92例患者，通过LAPSS进行卒中筛查，探讨LAPSS对院前卒中预后的影响。结果 通过LAPSS筛查，判断为“目标卒中”者49例。LAPSS筛查平均时间为280 s。经最后临床确诊后，发现漏诊4例，误诊4例。LAPSS筛查的灵敏度91.8%，特异度90.7%，Youden指数0.83，阳性似然比9.87，阴性似然比0.09。结论 LAPSS在院前卒中诊断中具有较高的特异性和敏感性，有助于快速、准确判断卒中，对脑卒中患者的院前救护有重要意义。

Abstract:

Objective To study the value of the Los Angeles Pre-hospital Stroke Screen (LAPSS) in the diagnosis of pre-hospital stroke. Methods A total of 92 patients in pre-hospital service with neurological symptoms and signs were screened for stroke by LAPSS. The screen Results were compared with the final clinical diagnosis.Results Among the 92 patients, there were 49 patients were identified with stroke by LAPSS. The average time to complete the LAPSS was 280 seconds. The final clinical diagnosis of stroke showed that there were 4 cases of missed diagnosis and 4 cases of error diagnosis by LAPSS. The sensitivity, specificity, and Youden index of LAPSS were 91.8%, 90.7% and 0.83, respectively. The positive and negative likelihood ratio was 9.87 and 0.09, respectively.Conclusions The LAPSS has higher specificity and sensitivity in pre-hospital diagnosis of stroke. It shows important values in emergency treatment of pre-hospital stroke.