Please use this identifier to cite or link to this item: doi:10.22028/D291-39805
Title: Effects of state-wide implementation of the Los Angeles Motor Scale for triage of stroke patients in clinical practice
Author(s): Behnke, Stefanie
Schlechtriemen, Thomas
Binder, Andreas
Bachhuber, Monika
Becker, Mark
Trauth, Benedikt
Lesmeister, Martin
Spüntrup, Elmar
Walter, Silke
Hoor, Lukas
Ragoschke-Schumm, Andreas
Merzou, Fatma
Tarantini, Luca
Bertsch, Thomas
Guldner, Jürgen
Magull-Seltenreich, Achim
Maier, Frank
Massing, Christoph
Fischer, Volkmar
Gawlitza, Michael
Donnevert, Katrin
Lamberty, Hans-Michael
Jung, Stefan
Strittmatter, Matthias
Tonner, Silke
Schuler, Johannes
Liszka, Robert
Wagenpfeil, Stefan
Grunwald, Iris Q
Reith, Wolfgang
Fassbender, Klaus
Language: English
Title: Neurological research and practice
Volume: 3
Issue: 1
Publisher/Platform: BioMed Central
Year of Publication: 2021
Free key words: Prehospital
Large-vessel occlusion
Emergency medical services
Preclinical scale
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: The prehospital identification of stroke patients with large-vessel occlusion (LVO), that should be immediately transported to a thrombectomy capable centre is an unsolved problem. Our aim was to determine whether implementation of a state-wide standard operating procedure (SOP) using the Los Angeles Motor Scale (LAMS) is feasible and enables correct triage of stroke patients to hospitals offering (comprehensive stroke centres, CSCs) or not offering (primary stroke centres, PSCs) thrombectomy. Prospective study involving all patients with suspected acute stroke treated in a 4-month period in a state-wide network of all stroke-treating hospitals (eight PSCs and two CSCs). Primary endpoint was accuracy of the triage SOP in correctly transferring patients to CSCs or PSCs. Additional endpoints included the number of secondary transfers, the accuracy of the LAMS for detection of LVO, apart from stroke management metrics. In 1123 patients, use of a triage SOP based on the LAMS allowed triage decisions according to LVO status with a sensitivity of 69.2% (95% confidence interval (95%-CI): 59.0–79.5%) and a specificity of 84.9% (95%-CI: 82.6–87.3%). This was more favourable than the conventional approach of transferring every patient to the nearest stroke-treating hospital, as determined by geocoding for each patient (sensitivity, 17.9% (95%-CI: 9.4–26.5%); specificity, 100% (95%-CI: 100–100%)). Secondary transfers were required for 14 of the 78 (17.9%) LVO patients. Regarding the score itself, LAMS detected LVO with a sensitivity of 67.5% (95%-CI: 57.1–78.0%) and a specificity of 83.5% (95%-CI: 81.0–86.0%). State-wide implementation of a triage SOP requesting use of the LAMS tool is feasible and improves triage decision-making in acute stroke regarding the most appropriate target hospital.
DOI of the first publication: 10.1186/s42466-021-00128-x
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-398056
ISSN: 2524-3489
Date of registration: 22-May-2023
Faculty: HW - Fakultät für Empirische Humanwissenschaften und Wirtschaftswissenschaft
M - Medizinische Fakultät
Department: HW - Psychologie
M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
Professorship: HW - Prof. Dr. Axel Mecklinger
M - Prof. Dr. Stefan Wagenpfeil
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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