急诊脑卒中识别评分量表对急性脑卒中患者的筛选价值探讨

The validation of the use of the ROSIER scale in a Chinese emergency department

目的探讨分析急诊脑卒中识别评分量表(the recognition of stroke in the emergency room scale,ROSIER)对急诊室可疑脑卒中患者的快速筛选价值。方法参照《中国脑血管病防治指南2007》,急诊医师在急诊室使用ROSIER对可疑脑卒中患者进行筛查,综合临床诊断将根据患者的急诊头颅CT或MRI扫描,并结合神经专科医师意见制定。计算ROSIER灵敏度、特异度、阴性预测值、阳性预测值、相关系数和Kappa值。结果本次研究的216例可疑脑卒中患者中,ROSIER的灵敏度90.0%,特异度84.2%,阳性预测值91.3%,阴性预测值82.1%,Kappa值为0.74,相关系数为0.59。在急诊室使用ROSIER对可疑脑卒中患者进行快速筛选,与综合临床诊断结果相关联,差异有统计学意义(P<0.05)。ROSIER对可疑脑卒中患者筛选结果的一致性为中高度一致。结论在急诊室,急诊医师使用ROSIER对可疑脑卒中患者进行筛选具有一定使用价值。

Objective to validate the use of the Recognition of Stroke in the Emergency Room （ROSIER） scale in a large Chinese emergency department（ED）. Methods According to China Guideline For Cerebmvascular Disease Prevention And Treatment 2007, the ROSIER scale were used on assessment of suspected stroke patients by emergency physicians prospectively in the ED. And the final diagnosis made by the consultant stroke physicians, after assessment and review of clinical symptomatology and brain imaging findings, was used as the reference standard for diagnosis in the study. Calculated the ROSIER scale like sensitivity（Se）, specificity（Sp）, negative predictive value （NPV）,positive predictive value（PPV）, related coefficient（r） and Kappa value. Results In this study, 216 suspected stroke patients were assessed in the ED. The ROSIER scale showed a diagnostic Se90.0%, Sp84.2%, PPV 91.3% and NPV 82.1%; According to the final diagnosis, the ROSIER was useful in stroke recognition in the ED （P 〈 0.05）. The Kappa statistic of the ROSIER scale and related coefficient（r） were 0.74 and 0.59, respectively. Conclusion The ROSIER scale could be used by emergency physicians as a useful stroke recognition instrument in the ED.