Design of emergency stroke recognition and severity scores
| Stroke recognition | Severity grading | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| CPSS | FAST | LAPSS* | MASS | Med PACS | ROSIER | KPSS | LAMS | sNIHSS-8 | sNIHSS-5 | |
| Consciousness/orientation | – | – | – | – | – | – | ● | – | ● | – |
| Gaze | – | – | – | – | ● | – | – | – | ● | ● |
| Visual | – | – | – | – | – | ● | – | – | ● | ● |
| Facial palsy | ● | ● | ● | ● | ● | – | – | ● | ● | ● |
| Motor arm | ● | ● | ● | ● | ● | ● | ● | ● | – | – |
| Motor leg | – | – | – | – | ● | ● | ● | – | ● | ● |
| Ataxia | – | – | – | – | – | – | – | – | – | – |
| Sensory | – | ●† | – | – | – | – | – | – | – | – |
| Language | }● | }● | – | }● | }● | }● | }● | – | ● | ● |
| Dysarthria | – | – | ● | – | ||||||
| Age limit (years) | – | – | 45 | 45 | – | – | – | – | – | – |
| History and acute seizures/Epilepsy‡ | – | – | ● | ● | ● | ● | – | – | – | – |
| Symptom duration (hours) | – | – | <127 | – | ≤25 | – | – | – | – | – |
| <2417 | ||||||||||
| Ambulatory prior to ictus | – | – | ● | ● | – | – | – | – | – | – |
| Blood glucose level (mg/dL) | – | – | 60–400§ | 50–400** | 60–400§ | ≥63†† | – | – | – | – |
*LAPSS referring to both versions of 1998 and 2000.7 ,17
†Assessment of sensory function was included in the original version but excluded in some later versions.
‡LAPSS, MASS and Med PACS seizure items are meant to include any history of seizures up to the moment that the evaluation itself is performed. The ROSIER seizure item refers only to acute seizures associated with the presenting event.
§3.3–22.2 mmol/L.
**2.8–22.2 mmol/L.
††≥3.5 mmol/L.
●, item included; –, item not included; Parenthesis: Combined assessment of language (aphasia) and dysarthria using one single item. CPSS, Cincinnati Prehospital Stroke Scale; FAST, Face Arm Speech Test; KPSS, Kurashiki Prehospital Stroke Scale; LAMS, Los Angeles Motor Scale; LAPSS, Los Angeles Prehospital Stroke Screen; MASS, Melbourne Ambulance Stroke Screen; Med PACS, Medic Prehospital Assessment for Code Stroke; ROSIER, Recognition of Stroke in the Emergency Room score; sNIHSS-8/sNIHSS-5, shortened National Institutes of Health Stroke Scale with 8, resp. 5 items.