• Home  
•  Vol. 34 No. 4 September 2017
•  Article Detail

Vol. 34 No. 4 September 2017

PERBEDAAN TINGKAT AKURASI SKALA FACE ARM SPEECH TEST, SKALA LOS ANGELES PRE-HOSPITAL STROKE SCREEN, DAN SKALA RECOGNITION OF STROKE IN THE EMERGENCY ROOM DALAM MENGIDENTIFIKASI PASIEN STROKE
Suska Lara Ginting,* Rusli Dhanu,* Fasihah Irfani Fitri*
COMPARISON OF THE DIAGNOSTIC ACCURACY OF FACE ARM SPEECH TEST, RECOGNITION OF STROKE IN EMERGENCY ROOM, AND LOS ANGELES PREHOSPITAL STROKE SCALE FOR IDENTIFICATION STROKE

ABSTRACT

Introduction: Accurate identification of stroke is important for delivering acute stroke therapies in hospital. The Face Arm Speech Test (FAST) is a brief, reliable tool that is simple to administer for stroke patient identification. The Recognition of Stroke in Emergency Room (ROSIER) is not better than the FAST for recognition of stroke. The paramedics of Beijing use Los Angeles Prehospital Stroke Scale (LAPSS) as a screening tool to identify stroke and also to exclude stroke mimics.

Aim: The aim of this study is to compare the diagnostic accuracy of FAST, LAPSS, ROSIER scale for identification stroke patient in emergency room.

Methods: A cross sectional study involving patients who were suspected as stroke and and refered from triage or other department in H. Adam Malik Hospital between September 2015 and February 2016. FAST, LAPSS, ROSIER scale, and Head CT scan were assessed for identification stroke patient.

Results: Sixty-six subjects, mostly males (54.5%), mean age 55,41±10,42 with right side paresis, were included in the study. FAST shows sensitivity 76.2% and specificity 66.7% as diagnostic value to identify stroke. Sensitivity of LAPSS scale is 39.7%, spesificity 66.7%. The ROSIER showes sensitivity 66,7%, spesificity 66,7%. No significant accuracy difference between FAST with ROSIER and LAPPS, and ROSIER with LAPSS.

Discussion: The FAST is better than LAPSS and ROSIER for identification stroke, although insignificant.

Keywords: Accuracy, Face Arm Speech Test, Identification Stroke, Los Angeles Prehospital Stroke Scale, Recognition of Stroke in Emergency Room Scale

ABSTRAK

Pendahuluan: Identifikasi pasien stroke yang akurat penting dalam pemilahan pasien untuk terapi stroke akut. Skala Face  Arm Speech Test (FAST) sederhana dan mudah digunakan untuk identifikasi stroke. Sebelumnya, skala Recognition of Stroke in Emergency Room (ROSIER) tidak lebih baik daripada FAST untuk mengidentifikasi stroke. Petugas paramedis di Beijing menggunakan Los Angeles Prehospital Stroke Scale (LAPSS) untuk mengidentifikasi stroke dan juga mengeksklusikan stroke mimics.

Tujuan: Untuk melihat perbedaan tingkat akurasi skala FAST, LAPSS, dan ROSIER dalam mengidentifikasi pasien stroke di IGD.

Metode: Penelitian secara potong lintang terhadap pasien yang dicurigai stroke dan dikonsulkan oleh dokter triase IGD atau departemen/bagian lain di RSUP H. Adam Malik (HAM), Medan pada bulan September 2015 hingga Februari 2016. Digunakan skala FAST, LAPSS, ROSIER, dan CT scan kepala terhadap semua subjek untuk mengidentifikasi adanya gejala stroke.

Hasil: Didapatkan 66 subjek yang mayoritas laki-laki (54,5%) dengan rerata usia 55,41±10,42 tahun dan keluhan utama berupa kelemahan tubuh sesisi (45,5%). Nilai diagnostik FAST dalam mengidentifikasi pasien stroke adalah sensitivitas 76,2% dan spesifisitas 66,7%. Sensitivitas skala LAPSS 39,7% dan spesifisitas 66,7%. ROSIER dengan sensitivitas 66,7% dan spesifisitas 66,7%. Namun tidak didapatkan hubungan yang bermakna antara akurasi skala FAST dengan ROSIER dan LAPSS, serta skala ROSIER dengan LAPSS.

Diskusi: Skala FAST mempunyai nilai sensitivitas yang lebih baik daripada LAPSS dan ROSIER, walaupun tidak bermakna.

Download Article