Diagnostic performance of the FAAS stroke screening tool FAAS stroke screening tool in patients who presented to the emergency room with neurological symptoms

Abstract

Background: Rapid screening and intervention are the keys to successful early treatment of stroke. In Thailand, the conventional FAST stroke screening tool has generally been used by triage nurses to promptly detect acute stroke. However, the FAST score has a limitation in detecting posterior circulation stroke. Previous studies showed that adding ataxia could increase the sensitivity of posterior circulation stroke detection. Therefore, we studied the performance of a new stroke screening tool, the FAAS score, among acute ischemic stroke patients. Objectives: To evaluate the diagnostic performance of the FAAS score and compare the diagnostic performance between FAAS and the conventional FAST score. Study design: Multicenter cross-sectional study. Materials and methods: The new FAAS and conventional FAST scores were used by triage nurses in patients who presented with acute neurological symptoms within 7 days at the emergency department of King Chulalongkorn Memorial Hospital, Nopparatrajathanee Hospital and Surin Hospital. Final diagnosis was made by a neurologist using clinical and neuroimaging information. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and the ROC curve were calculated using STATA version 14. Results: In total, 146 patients were enrolled. Of these, 127 (86 %) had acute ischemic stroke and 19 (14%) had other diagnoses. We found that the sensitivity of the FAAS stroke screening tool was higher than conventional FAST (96.85% vs 95.28%, p = 0.125). The FAAS stroke screening tool detected posterior circulation ischemic stroke better than conventional FAST (94.12% vs 82.35%, p=0.063). Conclusions: The FAAS stroke screening tool is sensitive for detecting acute stroke, especially posterior circulation stroke.