辛辛那提院前脑卒中识别评分量表筛选价值探讨

Value of Using Cincinnati Pre-hospital Stroke Scale in Pre-hospital Emergency Care

目的:研究辛辛那提院前脑卒中识别评分量表(CPSS)在院前急救中对可疑脑卒中患者的快速筛选价值。方法:急诊医师在院前急救中使用CPSS对可疑脑卒中患者进行筛查,最终诊断将根据患者的头颅CT或MRI,并结合神经专科医师意见制定。计算CPSS的灵敏度、特异度、阳性/阴性预测值、阳性/阴性似然比、相关系数和Kappa值。结果:在本研究的100例可疑脑卒中患者中CPSS的敏感度88.57%,特异度70.00%,阳性预测值87.32%,阴性预测值72.41%,阳性似然比2.95,阴性似然比0.16,相关系数0.592,Kappa值0.5913,使用CPSS对急诊可疑脑卒中患者进行筛选均有显著统计学意义(P<0.05)。结论:急诊医师在院前急救中使用CPSS对可疑脑卒中患者进行筛选有一定价值。

Objective： To explore the value of using Cincinnati pre-hospital stroke scale （CPSS） in pre-hospital emergency care. Method： Emergency physicians prospectively used the CPSS on suspected stroke cases got the prehospital emergency care, and the final diagnosis was made by consultant stroke physicians after assessment and review of clinical symptomatology and brain imaging findings. Calculated the CPSS such as sensitivity （Se）, specificity （Sp）, positive predictive value （PPV）, negative predictive value （NPV）, positive likelihood ratio （＋LR）, negative likelihood ratio （-LR）,linear likelihood ratio （r） and kappa value. Results： In the study, 100 suspected stroke cases were assessed in pre-hospital emergency care. The CPSS showed a diagnostic Se 88.57%, Sp 70.00%, PPV 87.32%, NPV72.41% ＋LR2.95,-LR0.16, r 0.592 and kappa value 0.5913. Consulted the final diagnosis, the CPSS was useful on the recognition of suspected stroke patients in pre-hospital emergency care P〈0.05. Conclusions： The CPSS is a useful stroke pre-hospital recognition tool in assessment of suspect stroke cases.