Diagnostic Accuracy of Recognition of Stroke in Emergency Room Score in Patients with Ischemic Stroke

Abstract

Objective: To determine the diagnostic accuracy of ROSIER scale in patients with ischemic stroke taking non-enhanced CT scan
brain as gold standard.
Materials and Methods: Cross-sectional study conducted at tertiary care hospital in Gujrat from October 2019 to December 2020. Patients of
both sex groups aged 30- 75 years presented in emergency within 24 hours of onset of focal neurological deficit which is objectively present
and suspected of ischemic stroke. 289 patients were included. Patient history and neurological examination done calculating ROSIER scale and
ischemic stroke diagnosed after CT scan brain done 24 hours after onset of symptoms. Sensitivity, specificity, PPV, NPV and diagnostic
accuracy of ROSIER scale were calculated. Data analysis was done using SPSS 20.0.
Results: In this study group 141(48.8%) were male while 148(51.2%) were female. Mean age was 62.1+11.02 years. 49(17%) patients were
aged <50 years while 240(83%) were aged >50 years. 215(74.4%) presented within 12 hours while 74(25.6%) after 12 hours of symptoms
onset. Sensitivity of ROSIER scale for diagnosing ischemic stroke was 98.86%(95%CI;95.96%-99.86%), specificity
5.31%(95%CI;1.97%-11.20%), PPV 61.92%(95% CI;60.82%-63.01%) and NPV was 75%(95%CI;38.13%-93.59%). LR+ was 1.04(95%CI;
1.00-1.09) while LR- was 0.21(95%CI; 0.04-1.04).
Conclusion: ROSIER score can be used as initial screening test in patients with stroke. It has high sensitivity but low specificity and is a good
test to rule in and rule out stroke patients.