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dc.contributor.authorHov, Maren Ranhoff
dc.contributor.authorRøislien, Jo
dc.contributor.authorLindner, Thomas Werner
dc.contributor.authorZakariassen, Erik
dc.contributor.authorBache, Kristi Cecilie Grønvold
dc.contributor.authorSolyga, Volker
dc.contributor.authorRussell, David
dc.contributor.authorLund, Christian
dc.PublishedEuropean journal of emergency medicine. 2019, 26 (3), 194-198.
dc.description.abstractBackground Cerebral revascularization in acute stroke requires robust diagnostic tools close to symptom onset. The quantitative National Institute of Health Stroke Scale (NIHSS) is widely used in-hospital, whereas shorter and less specific stroke scales are used in the prehospital field. This study explored the accuracy and potential clinical benefit of using NIHSS prehospitally. Patients and methods Thirteen anesthesiologists trained in prehospital critical care enrolled patients with suspected acute stroke in a mobile stroke unit. NIHSS was completed twice in the acute phase: first prehospitally and then by an on-call resident neurologist at the receiving hospital. The agreement between prehospital and in-hospital NIHSS scores was assessed by a Bland–Altman plot, and inter-rater agreement for predefined clinical categories was tested using Cohen’s κ. Results This Norwegian Acute Stroke Prehospital Project study included 40 patients for analyses. The mean numerical difference between prehospital and in-hospital NIHSS scores was 0.85, with corresponding limits of agreement from − 5.94 to 7.64. Inter-rater agreement (κ) for the corresponding clinical categories was 0.38. A prehospital diagnostic workup (NIHSS and computed tomographic examination) was completed in median (quartiles) 10 min (range: 7–14 min). Time between the prehospital and in-hospital NIHSS scores was median (quartiles) 40 min (32–48 min). Conclusion Critical care physicians in a mobile stroke unit may use the NIHSS as a clinical tool in the assessment of patients experiencing acute stroke. The disagreement in NIHSS scores was mainly for very low values and would not have changed the handling of the patients.en_US
dc.publisherLippincott, Williams & Wilkinsen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleStroke severity quantification by critical care physicians in a mobile stroke uniten_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2017 The Author(s).en_US
dc.source.journalEuropean Journal of Emergency Medicineen_US
dc.identifier.citationEuropean Journal of Emergency Medicine. 2019, 26 (3), 194-198.en_US

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