Distinguishing Non-Hemorrhagic From Hemorrhagic Stroke In Rural Nepal Setting Using The Besson Score
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
Introduction: The management and prognosis of patient with acute stroke varies depending mainly on stroke subtypes. Hence it is very crucial to make a timely differentiation between the stroke subtypes. Computed Tomography is largely unavailable in rural Nepal. This study identifies the diagnostic accuracy of Besson Score to distinguish stroke subtypes in Nepalese population.Methods: It was a prospective observational cross-sectional study conducted at United Mission Hospital Tansen. It included 71 patients presenting to UMHT with acute stroke. Besson Score was calculated and was compared with Computed Tomography (CT) of head.Results: A total of 71 patients were included in this study, out of them 27 patients had hemorrhagic stroke and 44 had non-hemorrhagic stroke. This study showed that sensitivity and specificity for Besson score for non-hemorrhagic stroke were 45.45% and 96.30% respectively. The positive likelihood ratio was 13.18 and the negative likelihood ratio was 0.57. Positive predictive value of the Besson score was 95.24% for non-hemorrhagic stroke.Conclusions: This scoring system is not accurate enough to replace CT scan as investigation of choice but can be used in resource poor settings in order to minimize referral and to manage the cases with non-hemorrhagic stroke at rural hospitals.
Authors and Affiliations
BasantaGautam MD, Tirtha Man Shrestha MD, BikashShrestha MD
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