Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST): A Modified Scale to Detect Large Vessel Occlusion Stroke

Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), this requirement presents a big challenge to current systems of delivering appropriate patients to comprehensive stroke centers (CSC). It is thus critical for emergency paramedics to precisely identify LVOS in the setting of pre-hospital triage stage (14, 15). Current guideline recommends the use of National Institutes of Health Stroke Scale (NIHSS) scores ≥6 to select patients for EVT (16), as patients with acute LVOS are strongly associated with high NIHSS (17–19). However, in the pre-hospital triage stage, it is not very practical to complete the whole examination of NIHSS. Actually, certain items of NIHSS may be more informative of LVOS than a simple score, which usually reflects the overall severity of deficits. Thus, several examination tools derived from NIHSS have been proposed for use in the pre-hospital setting (14, 20–25), ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research