Scholarlink

<p>Early identification of large vessel occlusion (LVO) in acute ischemic stroke is critical, as the benefit of reperfusion therapies diminishes rapidly with time. Although multiple prehospital stroke severity scales exist, most require direct bedside assessment by trained personnel, with limited evidence supporting telephone-based LVO recognition. This study aimed to develop the DAFNES scale and conduct preliminary internal hospital-based validation for LVO identification in patients with suspected acute stroke. A prospective observational study enrolled 593 consecutive patients with suspected stroke admitted to the Emergency Department of a tertiary hospital (January-September 2024). Following exclusion of stroke mimics and intracerebral hemorrhages, 408 patients were analyzed. The DAFNES scale comprises six binary items: oculocephalic deviation, aphasia, facial droop, neglect, hemiparesis, and altered consciousness. Scores were assigned bedside by expert neurologists blinded to CT angiography findings. LVO status was determined by a blinded neurologist based on CT angiography results. Among 408 analyzed patients, 185 (45.3%) presented with LVO and 223 (54.7%) with non-LVO ischemic stroke. The DAFNES scale demonstrated good discriminatory performance with an area under the curve of 0.79 (95% CI 0.75–0.83). At a cutoff score of ≥ 3: sensitivity was 0.78, specificity 0.72, positive predictive value 0.70, and negative predictive value 0.80. Median DAFNES scores were significantly higher in LVO patients compared to non-LVO patients. The DAFNES scale demonstrates promising discriminatory ability for LVO detection in hospital-based cohorts. However, formal prehospital and dispatcher-based validation studies are required before clinical implementation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

DAFNES scale for large vessel occlusion in Ischemic Stroke : development and preliminary internal validation

  • 期刊论文

  • 发表日期：

    2026年7月16日

查看全文
  • Alessandra Murialdo Murialdo,
  • Davide Sassos,
  • Stefano Ricci,
  • Paolo Eusebi,
  • Sara Cazzulo,
  • Antonella Picchioni,
  • Andrea Furgani,
  • Erica Biassoni,
  • Fabio Bandini,
  • Massimo Del Sette

摘要

Early identification of large vessel occlusion (LVO) in acute ischemic stroke is critical, as the benefit of reperfusion therapies diminishes rapidly with time. Although multiple prehospital stroke severity scales exist, most require direct bedside assessment by trained personnel, with limited evidence supporting telephone-based LVO recognition. This study aimed to develop the DAFNES scale and conduct preliminary internal hospital-based validation for LVO identification in patients with suspected acute stroke. A prospective observational study enrolled 593 consecutive patients with suspected stroke admitted to the Emergency Department of a tertiary hospital (January-September 2024). Following exclusion of stroke mimics and intracerebral hemorrhages, 408 patients were analyzed. The DAFNES scale comprises six binary items: oculocephalic deviation, aphasia, facial droop, neglect, hemiparesis, and altered consciousness. Scores were assigned bedside by expert neurologists blinded to CT angiography findings. LVO status was determined by a blinded neurologist based on CT angiography results. Among 408 analyzed patients, 185 (45.3%) presented with LVO and 223 (54.7%) with non-LVO ischemic stroke. The DAFNES scale demonstrated good discriminatory performance with an area under the curve of 0.79 (95% CI 0.75–0.83). At a cutoff score of ≥ 3: sensitivity was 0.78, specificity 0.72, positive predictive value 0.70, and negative predictive value 0.80. Median DAFNES scores were significantly higher in LVO patients compared to non-LVO patients. The DAFNES scale demonstrates promising discriminatory ability for LVO detection in hospital-based cohorts. However, formal prehospital and dispatcher-based validation studies are required before clinical implementation.