TriAGe+ Score and NSE for Detecting Acute Ischemic Stroke in Acute Isolated Dizziness: A Propensity Score Matching...

Acute isolated dizziness often presents diagnostic challenges, as peripheral vestibular disorders (PVD) and acute ischemic stroke (AIS) symptoms overlap. This study aimed to evaluate the diagnostic effectiveness of the TriAGe+ score, serum neuron-specific enolase (NSE), and their combination in differentiating AIS from PVD.

A retrospective analysis was conducted on patients hospitalized for acute isolated dizziness in our hospital. Propensity score matching (PSM) was used to balance general demographic characteristics between patient groups. Univariate and multivariate logistic regression analyses were conducted to investigate the associations of TriAGe+ scores and NSE levels with acute cerebral infarction. The predictive performance of these parameters was assessed using receiver operating characteristic (ROC) curves.

A total of 256 eligible patients were enrolled, and 78 pairs were successfully matched using PSM. After PSM, these covariates were well balanced. Logistic regression analysis revealed that NSE level (OR=1.409, 95% CI: 1.233-1.611, P <0.001) and TriAGe+ score (OR=1.938, 95% CI: 1.244-1.851, P <0.001) were independent risk factors. ROC analysis demonstrated that NSE alone had a sensitivity of 74.36%, specificity of 84.62%, and an AUC of 0.82, while the TriAGe+ score had a sensitivity of 67.95%, specificity of 69.23%, and an AUC of 0.74. Combining NSE level and TriAGe+ score resulted in a sensitivity of 74.36%, specificity of 84.62%, and an improved AUC of 0.87.

Elevated TriAGe+ scores and serum NSE levels are associated with an increased risk of AIS in patients with acute isolated dizziness. Their combination may enhance predictive accuracy.