Abstract

Background and Objective: Stroke burden in India and all over the world is already high and is increasing, but limited patients with stroke have access to brain imaging. Distinguishing pathologic stroke types is relevant both for clinical management and epidemiologic studies. We assessed the accuracy of two stroke scores which are based on clinicians assessment of patient in distinguishing stroke subtypes and compared them with the computed tomography brain scanning as the “gold standard.” Methodology: This comparative, analytical study was conducted at Shri. V.N. Govt. Medical College, from December 2012 to July 2015. Study included 150 consecutive patients of acute stroke admitted to our hospital. ASS and SSS were calculated for each patient and compared with the results of CT scan(sensitivity, specificity, positive predictive value, likelihood ratio, kappa statistics). Results: Out of 150 patients, 105 had CI and 45 had CH. The overall comparability of ASS and SSS was good (Kappa=0.728). SSS was equivocal in 5 cases. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SSS was 87.62%; 84.44%; 92.93% and74.51% respectively for CI and 82..22%, 87.62%, 74% and 92% respectively for CH. The sensitivity, specificity, PPV and NPV of ASS was 87.62%, 73.33%, 88.46% and 71.74% respectively for CI and 73.33%, 87.62%, 71.74% and 88.46% respectively for CH. Conclusion: Although, SSS simple to calculate and being more accurate is better than ASS, both these scores lack sufficient validity to be used for exclusion of intracerebral hemorrhage so cannot be used to offer high risk thrombolytic therapy.

Authors and Affiliations