Trial reportJournal of neurointerventional surgery2020
Long-term implementation of a prehospital severity scale for EMS triage of acute stroke: a real-world experience.
Trial report in Journal of neurointerventional surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stroke Scales for Large Vessel Occlusion in the Prehospital Emergency Setting: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2026Pooled it
- Variation in Prehospital Routing Patterns for Patients With Suspected Stroke.Journal of the American Heart Association · 2025Article
- Validation of the Ultimate Stroke Scale (USS): A standardized tool for automated large vessel occlusion screening.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Large-Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States.Stroke (Hoboken, N.J.) · 2025Article
- A Two-Step Approach Using the National Health Institutes of Health Stroke Scale Assessed by Paramedics to Enhance Prehospital Stroke Detection: A Case Report and Concept Proposal.Journal of clinical medicine · 2024Article
- Prehospital identification of acute ischaemic stroke with large vessel occlusion: a retrospective study from western Norway.Emergency medicine journal : EMJ · 2024Article
- Implementation of a Thrombectomy Stroke Center Triage Program in New York City Emergency Medical Services.Stroke (Hoboken, N.J.) · 2024Article
- Rapid Arterial Occlusion Evaluation (RACE) Tool in Detecting Large Cerebral Vessel Occlusions; a Systematic Review and Meta-Analysis.Archives of academic emergency medicine · 2024Review
- Modeling the Decay in Probability of Receiving Endovascular Thrombectomy on the Basis of Time From Stroke Onset.Stroke (Hoboken, N.J.) · 2023Article
- Prehospital Stroke Care Part 1: Emergency Medical Services and the Stroke Systems of Care.Stroke · 2023Review
- Evolving Stroke Systems of Care: Stroke Diagnosis and Treatment in the Post-Thrombectomy Era.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023Review
- Prehospital triage tools across the world: a scoping review of the published literature.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Prehospital-Stroke-Scale Parameterized Hospital Selection Protocol for Suspected Stroke Patients Considering Door-to-Treatment Durations.Journal of the American Heart Association · 2022Article
- Performance of the vision, aphasia, neglect (VAN) assessment within a single large EMS system.Journal of neurointerventional surgery · 2022Article
- Stroke Network of Wisconsin (SNOW) Scale Predicts Large Vessel Occlusion Stroke in the Prehospital Setting.Journal of patient-centered research and reviews · 2022Article
- Large Vessel Occlusion Stroke Detection in the Prehospital Environment.Current emergency and hospital medicine reports · 2021Article
- [Comparison of RACE scale to other assessment scales for large vessel arterial occlusions in the out-of-hospital level: a rapid review].Anales del sistema sanitario de Navarra · 2021Review
- Sensitivity of prehospital stroke scales for different intracranial large vessel occlusion locations.European stroke journal · 2021Article
- An Online Training Intervention on Prehospital Stroke Codes in Catalonia to Improve the Knowledge, Pre-Notification Compliance and Time Performance of Emergency Medical Services Professionals.International journal of environmental research and public health · 2020Article
- Challenges Related to the Implementation of an EMS-Administered, Large Vessel Occlusion Stroke Score.The western journal of emergency medicine · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundData on the implementation of prehospital large vessel occlusion (LVO) scales to identify and triage patients with acute ischemic stroke (AIS) in the field are limited, with the majority of studies occurring outside the USA.
objectiveTo report our long-term experience of a US countywide emergency medical services (EMS) acute stroke triage protocol using the Rapid Arterial oCclusion Evaluation (RACE) score.
methodsOur prospective database was used to identify all consecutive patients triaged within Lucas County, Ohio by the EMS with (1) a RACE score ≥5, taken directly to an endovascular capable center (ECC) as RACE-alerts (RA) and (2) a RACE score <5, taken to the nearest hospital as stroke-alerts (SA). Baseline demographics, RACE score, time metrics, final diagnosis, treatments, and clinical and angiographic outcomes were captured. The sensitivity and specificity for patients with a RACE score ≥5 with LVO, eligible for mechanical thrombectomy (MT), were calculated.
resultsBetween July 2015 and June 2018, 492 RA and 1147 SA were triaged within our five-hospital network. Of the RA, 37% had AIS secondary to LVOs. Of the 492 RA and 1147 SA, 125 (25.4%) and 38 (3.3%), respectively, underwent MT (OR=9.9; 95% CI 6.8 to 14.6; p<0.0001). Median times from onset-to-ECC arrival (74 vs 167 min, p=0.03) and dispatch-to-ECC arrival (31 vs 46 min, p=0.0002) were shorter in the RA-MT than in the SA-MT cohort. A RACE cut-off point ≥5 showed a sensitivity and specificity of 0.77 and 0.75 for detection of patients with LVO eligible for MT, respectively.
conclusionsWe have demonstrated the long-term feasibility of a countywide EMS-based prehospital triage protocol using the RACE Scale within our hospital network.
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