Validation of the Cincinnati Prehospital Stroke Scale

Area of Science:

• Neurology
• Emergency Medicine
• Public Health

Background:

• Early stroke recognition is crucial for the "Chain of Survival."
• Prehospital stroke assessment tools include the Cincinnati Prehospital Stroke Scale (CPSS), Face Arm Speech Test, and Los Angeles Prehospital Stroke Screen.
• CPSS and Face Arm Speech Test identify stroke via physical findings; Los Angeles Prehospital Stroke Screen rules out other causes of altered consciousness.

Purpose of the Study:

• Validate the CPSS by correlating prehospital findings with CT scan results.
• Assess CPSS implementation feasibility in the Indian prehospital setting.
• Evaluate the utility of CPSS for early stroke detection in new emergency departments.

Main Methods:

• Prospective, observational study conducted from December 2015 to March 2016.
• Patients with suspected stroke were enrolled, with prehospital data collected upon ambulance arrival at the ED.
• Calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) using standard formulas.

Main Results:

• Combined CPSS demonstrated 81% sensitivity (CI: 68.5%-97%) and 100% PPV (CI: 91.9%-100%).
• Individual components showed sensitivities of 75.8%, 79%, and 74.1%, with 100% PPV and 95%-100% specificity.

Conclusions:

• CPSS is a valuable prehospital screening tool for suspected stroke.
• Its high sensitivity and PPV support its use for provisional stroke diagnosis.
• CPSS aids in early detection, pending confirmation by hospital investigations.