Biomaterial Database

Prehospital triage of patients with suspected stroke symptoms (PRESTO): protocol of a prospective observational study. 2019

Esmee Venema, and Martijne H C Duvekot, and Hester F Lingsma, and Anouk D Rozeman, and Walid Moudrous, and Frederique H Vermeij, and Marileen Biekart, and Aad van der Lugt, and Henk Kerkhoff, and Diederik W J Dippel, and Bob Roozenbeek, and

Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.

The efficacy of both intravenous treatment (IVT) and endovascular treatment (EVT) for patients with acute ischaemic stroke strongly declines over time. Only a subset of patients with ischaemic stroke caused by an intracranial large vessel occlusion (LVO) in the anterior circulation can benefit from EVT. Several prehospital stroke scales were developed to identify patients that are likely to have an LVO, which could allow for direct transportation of EVT eligible patients to an endovascular-capable centre without delaying IVT for the other patients. We aim to prospectively validate these prehospital stroke scales simultaneously to assess their accuracy in predicting LVO in the prehospital setting. Prehospital triage of patients with suspected stroke symptoms (PRESTO) is a prospective multicentre observational cohort study in the southwest of the Netherlands including adult patients with suspected stroke in the ambulance. The paramedic will assess a combination of items from five prehospital stroke scales, without changing the normal workflow. Primary outcome is the clinical diagnosis of an acute ischaemic stroke with an intracranial LVO in the anterior circulation. Additional hospital data concerning the diagnosis and provided treatment will be collected by chart review. Logistic regression analysis will be performed, and performance of the prehospital stroke scales will be expressed as sensitivity, specificity and area under the receiver operator curve. The Institutional Review Board of the Erasmus MC University Medical Centre has reviewed the study protocol and confirmed that the Dutch Medical Research Involving Human Subjects Act (WMO) is not applicable. The findings of this study will be disseminated widely through peer-reviewed publications and conference presentations. The best performing scale, or the simplest scale in case of clinical equipoise, will be integrated in a decision model with other clinical characteristics and real-life driving times to improve prehospital triage of suspected stroke patients. NTR7595.

UI	MeSH Term	Description	Entries
D009426	Netherlands	Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES.	Holland,Kingdom of the Netherlands
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D002341	Carotid Artery Thrombosis	Blood clot formation in any part of the CAROTID ARTERIES. This may produce CAROTID STENOSIS or occlusion of the vessel, leading to TRANSIENT ISCHEMIC ATTACK; CEREBRAL INFARCTION; or AMAUROSIS FUGAX.	Thrombosis, Carotid Artery,Carotid Thrombosis,Common Carotid Artery Thrombosis,External Carotid Artery Thrombosis,Internal Carotid Artery Thrombosis,Thrombosis, Carotid,Thrombosis, Common Carotid Artery,Thrombosis, External Carotid Artery,Thrombosis, Internal Carotid Artery,Carotid Artery Thromboses
D002343	Carotid Artery, Internal	Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.	Arteries, Internal Carotid,Artery, Internal Carotid,Carotid Arteries, Internal,Internal Carotid Arteries,Internal Carotid Artery
D004632	Emergency Medical Services	Services specifically designed, staffed, and equipped for the emergency care of patients.	Emergency Care,Emergency Health Services,Emergicenters,Prehospital Emergency Care,Emergency Care, Prehospital,Emergency Services, Medical,Medical Services, Emergency,Services, Emergency Medical,Emergency Health Service,Emergency Medical Service,Emergency Service, Medical,Emergicenter,Health Service, Emergency,Health Services, Emergency,Medical Emergency Service,Medical Emergency Services,Medical Service, Emergency,Service, Emergency Health,Service, Emergency Medical,Service, Medical Emergency,Services, Emergency Health,Services, Medical Emergency
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012372	ROC Curve	A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.	ROC Analysis,Receiver Operating Characteristic,Analysis, ROC,Analyses, ROC,Characteristic, Receiver Operating,Characteristics, Receiver Operating,Curve, ROC,Curves, ROC,ROC Analyses,ROC Curves,Receiver Operating Characteristics
D012680	Sensitivity and Specificity	Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)	Specificity,Sensitivity,Specificity and Sensitivity
D014218	Triage	The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.	Triages
D015912	Thrombolytic Therapy	Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.	Fibrinolytic Therapy,Thrombolysis, Therapeutic,Therapeutic Thrombolysis,Therapy, Fibrinolytic,Therapy, Thrombolytic,Fibrinolytic Therapies,Therapeutic Thrombolyses,Therapies, Fibrinolytic,Therapies, Thrombolytic,Thrombolyses, Therapeutic,Thrombolytic Therapies