ABSTRACT NUMBER: ESOC2026A1115 SWANSEA STROKE SCALE- A VALIDATED CLINICAL SCALE FOR USE BY MULTI-DISCIPLINARY STAFF IN ACUTE STROKE

Abstract Background and aims In the United Kingdom, there is shortage of Stroke specialists. Multi-disciplinary teams (health care support workers, physician associates, resident doctors and stroke nurses) increasingly deliver post-stroke care. Neurological decline in acute phase could be missed due to lack of simple neurological examination. We developed the Swansea Stroke Scale (SSS), a tool similar to the Glasgow Coma Scale, but specific to stroke for this staff cohort. The SSS evaluates 5 constructs- Situation, Sight, Speech, Oral intake and Movement. Scores range from 5 (no deficits) to 20 (maximal deficits). This study validates the SSS against the specialist-led National Institute of Health Stroke Scale (NIHSS). Methods Approved by the Research Ethics committee, study recruited 135 stroke survivors, over 18 years, in acute stroke unit with symptom onset <7 days. Convergent validity evaluated with paired assessments of SSS and NIHSS on Day 1; preadmission modified Rankin score (mRS) used for divergent validity. Two non-specialists on Day 2 evaluated inter-rater agreement via independent SSS assessments. 30 days outcome used for predictive validity. Results Pearson’s Correlation 0.924 (p<0.001, 95% CI 0.895-0.945) between SSS and NIHSS indicates strong convergent validity. Divergent validity was confirmed by low correlation with pre-admission mRS (r=0.18, p=0.037). Intraclass correlation of 0.99 (p<0.001, 95% CI 0.987-0.993) between two assessors showed excellent inter-rater agreement. SSS is statistically significant (F 18.71, p<0.001) for 30 day disposition. Conclusions The new stroke scale for non-specialists revealed strong validity and reliability against NIHSS by specialists, has good 30-day outcome prediction with wider implications in areas deficient of stroke specialists. Conflict of interest M Krishnan: nothing to disclose. W Y Cheung: nothing to disclose. S Storton: nothing to disclose. S Winsor: nothing to disclose. R Rai: nothing to disclose. G Edwards: nothing to disclose. E Evans: nothing to disclose. H Breeze-Jones: nothing to disclose. S C Bain: nothing to disclose. R A Thomas: nothing to disclose