1388 Utilization of Pre-Hospital Large Vessel Occlusion Scales in Hospital Settings

INTRODUCTION: Prehospital stroke scales have proven to be successful in pre-hospital triaging to help expedite management and may carry further utility in hospital settings including the ED and inpatient settings to expedite management and treatment. METHODS: In this single center prospective study, eight SSSs (BE-FAST, LAMS, PASS, FAST-ED, EMS RACE, 3-ISS, VAN, and NIHSS) were used to assess all stroke codes between January 2022-December 2023 for emergency room and inpatient ward patients. Potential diagnoses included AIS-LVO, AIS-MeVO, AIS without LVO or MeVO, intracranial hemorrhage, transient ischemic attack (TIA), or stroke mimic. RESULTS: 199 patients met study inclusion criteria. Within this cohort, the mean age was 63.8 ± 15.2 years, 62.3% were female (n=124), and 84.4% were African American/Black (n=168). AIS-LVO and AIS-MeVO were respectively diagnosed in 12.6% (n=25) and 8.0% (n=16) of all stroke codes. Endovascular thrombectomy was performed in 68.3% (n=28) and 2.3% (n=1) of AIS-LVO and AIS-MeVO stroke codes. The LAMS score ranked highest (AUC: 0.750 [95% CI: 0.668-0.831]) for detecting ischemic strokes with both LVO and MeVOs, followed by the FAST-ED (AUC: 0.736 [95% CI: 0.649-0.822]), and VAN (AUC: 0.735 [95% CI: 0.651-0.818]) scales. CONCLUSIONS: In this first prospective cohort study to directly compare eight SSSs in hospital settings, the LAMS scale was determined to be the most definitive tool for diagnosing patients with AIS-LVO and AIS-MeVO, followed by the FAST-ED and VAN scales.