急诊脑卒中识别评分量表在院前急救中筛选价值的探讨

目的:探讨急诊脑卒中识别评分量表(ROSIER)在院前急救筛选中的应用价值。方法:收集2013年1月至2014年1月期间,我院急诊科收治的可疑脑卒中病例114例,在院前急救中应用ROSIER量表筛查,并以辛辛那提院前脑卒中识别评分量表(CPSS)作为对照,以头颅CT或MRI检查、神经专科医师意见作为最终诊断,比较ROSIER与CPSS的对于脑卒中的筛选价值。结果:ROSIER对脑卒中的特异度、阳性似然比依次为83.67%、4.80,均显著高于CPSS的67.35%、2.36(P0.05);假阳性为16.33%,显著低于CPSS的32.65%;ROSIER的Kappa值为0.621,显著高于CPSS的0.462,差异具有统计学意义(P0.05);两组的敏感度、假阴性率及阴性拟然比无明显差异(P0.05)。结论:ROSIER应用于脑卒中筛查具有较高的敏感度和特异度,对于脑卒中的院前筛查以及院前急救具有重要指导意义。

Value of the Recognition of Stroke in the Emergency Room Scale in Pre-hospital Emergency

Objective:To investigate the value of the recognition of stroke in the emergency room scal (ROSIER) in pre-hospital emergency.Methods:114 cases of suspicious stroke patients admitted to the emergency department of our hospital between January 2013 and January 2014 were collected, all received ROSIER scale screening in pre-hospital emergency, and compared with the Cincinnati Pre-hospital Stroke Scale (CPSS). The value of ROSIER and CPSS in pre-hospital emergency was compared.Results:The specificity and positive likelihood ratio of ROSIER were 83.67%, 4.80, all significantly higher than the 67.35%, 2.36 of CPSS (P<0.05); the false positive, of ROSIER was 16.33%, significantly lower than the 32.65% of CPSS (P<0.05); the Kappa value of ROSIER was 0.621, significantly higher than 0.462 of CPSS, there was a significant difference (P<0.05); the sensitivity, the false negative rate and negative likelihood ratio of the two groups, was no significant difference (P>0.05).Conclusion:ROSIER applied in stroke screening has high sensitivity and specificity, has important value for pre-hospital screening and pre-hospital emergency of stroke.