CAJ | 학술논문

目的研究急诊脑卒中识别评分量表(the Recognition of Stroke in the Emergency Room Scale,ROSIER)对可疑脑卒中患者的快速筛选价值.方法以辛辛那提院前脑卒中评分量表(Cincinnati Pre-hospital Stroke Scale,CPSS)为对照,急诊医师在院前和院内急救中使用ROSIER对可疑脑卒中患者进行筛查,最终诊断将根据患者的头颅CT或MRI,并结合神经专科医师意见制定.比较ROSIER和CPSS的灵敏度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率、阳性似然比、阴性似然比、相关系数等指标.结果在本次研究的114例可疑脑卒中患者中,CPSS的敏感度76.9%,特异度69.4%,假阳性率30.6%,假阴性率23.1%,阳性似然比2.51,阴性似然比0.33,相关系数0.463;ROSIER的敏感度78.5%,特异度83.7%,假阳性率16.3%,假阴性率21.5%,阳性似然比4.81,阴性似然比0.26,相关系数0.616.参考最后诊断意见,使用ROSIER与CPSS对急诊可疑脑卒中患者进行筛选,Kappa值分别为0.622和0.463,差异有统计学意义(P<0.01),为中高度一致性,且ROSIER较CPSS关联程度要高.结论急诊院前和院内急救中使用ROSIER对可疑脑卒中患者进行筛选要优于CPSS,在中国大陆地区使用有一定价值.
목적 연구급진뇌졸중식별평분량표(the Recognition of Stroke in the Emergency Room Scale,ROSIER)대가의뇌졸중환자적쾌속사선개치.방법 이신신나제원전뇌졸중평분량표(Cincinnati Pre-hospital Stroke Scale,CPSS)위대조,급진의사재원전화원내급구중사용ROSIER대가의뇌졸중환자진행사사,최종진단장근거환자적두로CT혹MRI,병결합신경전과의사의견제정.비교ROSIER화CPSS적령민도、특이도、양성예측치、음성예측치、가양성솔、가음성솔、양성사연비、음성사연비、상관계수등지표.결과 재본차연구적114례가의뇌졸중환자중,CPSS적민감도76.9%,특이도69.4%,가양성솔30.6%,가음성솔23.1%,양성사연비2.51,음성사연비0.33,상관계수0.463;ROSIER적민감도78.5%,특이도83.7%,가양성솔16.3%,가음성솔21.5%,양성사연비4.81,음성사연비0.26,상관계수0.616.삼고최후진단의견,사용ROSIER여CPSS대급진가의뇌졸중환자진행사선,Kappa치분별위0.622화0.463,차이유통계학의의(P<0.01),위중고도일치성,차ROSIER교CPSS관련정도요고.결론 급진원전화원내급구중사용ROSIER대가의뇌졸중환자진행사선요우우CPSS,재중국대륙지구사용유일정개치.
Objective To explore the value of the use of the Recognition of Stroke in the Emergency Room (ROSIER) scale in a Chinese emergency department (ER). Methods Compared with the Cincinnati Pre-hospital Stroke Scale (CPSS), emergency physicians prospectively used the ROSIER scale for suspected stroke patients who were admitted to ER, and the final diagnosis was made by the consultant psy chiatrist after assessment and review of clinical symptomatology and brain imaging findings, which was used as the reference standard for diagnosis in the study. The sensitivity (Se), specificity (Sp), false negative rate (Fnr), false positive rate(Fpr), positive likelihood ratio(+LR), negative likelihood ratio(-LR), related coefficient (r) and so on were compared between the ROSIER scale and CPSS. Results In this study, 114 suspected stroke patients were assessed. The CPSS showed a diagnostic Se 76.9%, Sp 69.4%, Fpr 30.6%, Fnr 23.1%, +LR 2.51, -LR 0.33 and r 0.463;And the ROSIER scale showed a diagnostic Se 78.5%,Sp 83.7%, Fpr 16.3%, Fnr 21.5%, +LR 4.81, -LR 0.26 and r 0.616. According to the final diagnosis, both the CPSS and ROSIER scale were useful in the recognition of suspected stroke patients in the ER(P<0.01).The Kappa statistics of the ROSIER scale and CPSS were 0.622 and 0.463 in the study. Conclusion The ROSIER scale which was better than the CPSS was a useful stroke recognition tool in the assessment of suspected stroke patients in China.