Abstract:

Objective To investigate the application value of three stroke screening scales FAST, recognition of stroke in the emergency room (ROSIER) and Los Angeles prehospital stroke screen (LAPSS) in rapid referral of suspected stroke patients in the community. Methods The suspected stroke patients who were initially treated in Dongxiaokou Community Health Service Center of Changping District and Yongning Community Health Service Center of Yanqing District in Beijing from January 2018 to September 2019 were screened by FAST, ROSIER and LAPSS scales, respectively. According to the final diagnosis of patients in superior hospitals, they were divided into stroke group and non-stroke group. The accuracy, sensitivity and specificity of the three evaluation scales were compared. Results A total of 309 patients were enrolled, with an average age of 70.5±11.6 years and 156 males (50.5%). There were 243 cases (78.6%) in stroke group and 66 cases (21.4%) in non-stroke group. The accuracy of FAST, ROSIER and LAPSS in stroke screening was 92.2%, 71.5% and 67.3% (P <0.001),respectively. The sensitivity is 94.2%, 66.3% and 60.5% (P <0.001), respectively. The specificity was 84.8%, 90.9%, and 92.4% (P =0.327), respectively. Further pairwise comparison showed that the accuracy and sensitivity of FAST were better than that of ROSIER and LAPSS (all P <0.001). Conclusions FAST scale has a good application value, and it is suitable to be a tool for rapid referral of newly diagnosed suspected stroke patients in the community.

Key words: Stroke; Screening scale; Community; Referral

摘要：

目的 探讨FAST、急诊卒中识别（recognition of stroke in the emergency room，ROSIER）、洛杉矶院前 卒中筛查（Los Angeles prehospital stroke screen，LAPSS）三种卒中筛查量表在社区疑诊卒中患者快速 转诊中的应用价值。 方法 纳入2018年1月-2019年9月在北京市昌平区东小口社区卫生服务中心和延庆区永宁社区卫生 服务中心就诊的疑似卒中患者，分别用FAST、ROSIER、LAPSS三种量表进行卒中初筛，按照上级医院 患者最终诊断分为卒中组和非卒中组，比较三种评价量表筛查卒中的准确率、灵敏度和特异度。 结果 共纳入309例患者，平均年龄70.5±11.6岁，其中男性156例（50.5%）。卒中组243例（78.6%）， 非卒中组66例（21.4%）。FAST、ROSIER和LAPSS三种量表筛查卒中的准确率分别为92.2%、71.5%、 67.3%（P＜0.001），灵敏度分别为94.2%、66.3%、60.5%（P＜0.001），特异度分别为84.8%、90.9%、 92.4%（P =0.327）；进一步两两比较，FAST量表准确率、灵敏度均高于ROSIER和LAPSS量表（均P ＜0.001）。 结论 FAST量表的应用价值较好，适合社区医生作为初诊疑似卒中患者快速转诊的判断工具。

关键词: 卒中; 筛查量表; 社区; 转诊