SO SÁNH THANG ĐIỂM G-FAST VÀ PASS TRONG DỰ ĐOÁN TẮC ĐỘNG MẠCH NÃO LỚN Ở BỆNH NHÂN NHỒI MÁU NÃO

Abstract

Backgrounds: Endovascular mechanical thrombectomy is a treatment method for acute ischemic stroke caused by large artery occlusion. The availability of this treatment varies across medical facilities, and the success of the procedure depends on timing. Early identification of the risk of large artery occlusion in stroke patients is crucial for optimizing treatment outcomes. Objectives: To compare the sensitivity, specificity, and accuracy of two scoring systems, G-FAST and PASS, in predicting large artery occlusion. The research involved 142 patients admitted to Nghean Friendship General Hospital between September 2021 and May 2022. The patients were diagnosed with ischemic stroke, aged 18 and above, underwent brain imaging, and had symptom onset to hospital admission time of less than 6 hours. The G-FAST and PASS scores were assessed upon admission before reperfusion therapy. Results: Among the 142 patients with acute ischemic stroke, 65 had large artery occlusion, while 77 did not. The average age was 66.8 ± 11.88, with 66.2% being male. PASS showed a sensitivity of 64.6%, lower than the sensitivity of G-FAST at 81.5%, and a specificity of 90.9%, higher than the specificity of G-FAST at 27.3%. The AUC (Area Under the Curve) of PASS was 0.781 (p < 0.001), higher than the AUC of G-FAST at 0.579 (p = 0.039). Conclusions: PASS demonstrates better discriminative ability than G-FAST. In clinical practice, alongside symptom onset time and estimated transport time to the nearest stroke center, identifying the risk of large artery occlusion in suspected stroke patients plays a crucial role in selecting treatment facilities and deciding transportation strategies. Further research is needed to evaluate the accuracy of the two scoring systems.