ArticleNeurological research and practice2021
Effects of state-wide implementation of the Los Angeles Motor Scale for triage of stroke patients in clinical practice.
Article in Neurological research and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 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
- Neurologic Improvement in Acute Cerebral Ischemia: Frequency, Magnitude, Predictors, and Clinical Outcomes.Neurology · 2023Trial
- A Review of emergency medical services for stroke.African health sciences · 2024Review
- Review
- Unveiling the performance of the prehospital Rapid Emergency Medicine Score (pREMS): How the predictive score impacts in-hospital outcomes in traumatic brain injury (TBI): A retrospective observational cohort study.BMC emergency medicine · 2024Observational
- The creation, implementation, and harmonisation of medical standard operating procedures and checklists of Finnish Helicopter Emergency Medical Service units.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Prehospital stroke management and mobile stroke units.Current opinion in neurology · 2023Review
- National implementation of reperfusion for acute ischaemic stroke in England: How should services be configured? A modelling study.European stroke journal · 2022Article
- European Stroke Organisation (ESO) guidelines on mobile stroke units for prehospital stroke management.European stroke journal · 2022Article
- Modeling the Impact of Prehospital Triage on a True-Life Drip and Ship Mechanical Thrombectomy Urban Patient Cohort.Cerebrovascular diseases extra · 2021Article
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Authors and funding
31 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prehospital identification of stroke patients with large-vessel occlusion (LVO), that should be immediately transported to a thrombectomy capable centre is an unsolved problem. Our aim was to determine whether implementation of a state-wide standard operating procedure (SOP) using the Los Angeles Motor Scale (LAMS) is feasible and enables correct triage of stroke patients to hospitals offering (comprehensive stroke centres, CSCs) or not offering (primary stroke centres, PSCs) thrombectomy.
methodsProspective study involving all patients with suspected acute stroke treated in a 4-month period in a state-wide network of all stroke-treating hospitals (eight PSCs and two CSCs). Primary endpoint was accuracy of the triage SOP in correctly transferring patients to CSCs or PSCs. Additional endpoints included the number of secondary transfers, the accuracy of the LAMS for detection of LVO, apart from stroke management metrics.
resultsIn 1123 patients, use of a triage SOP based on the LAMS allowed triage decisions according to LVO status with a sensitivity of 69.2% (95% confidence interval (95%-CI): 59.0-79.5%) and a specificity of 84.9% (95%-CI: 82.6-87.3%). This was more favourable than the conventional approach of transferring every patient to the nearest stroke-treating hospital, as determined by geocoding for each patient (sensitivity, 17.9% (95%-CI: 9.4-26.5%); specificity, 100% (95%-CI: 100-100%)). Secondary transfers were required for 14 of the 78 (17.9%) LVO patients. Regarding the score itself, LAMS detected LVO with a sensitivity of 67.5% (95%-CI: 57.1-78.0%) and a specificity of 83.5% (95%-CI: 81.0-86.0%).
conclusionsState-wide implementation of a triage SOP requesting use of the LAMS tool is feasible and improves triage decision-making in acute stroke regarding the most appropriate target hospital.
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