The Accuracy of CPSS, LAPSS and MASS in Terms of Early Acute Ischemic Stroke Diagnosis

Abstract

Aim: This study aimed to investigate the diagnostic accuracy of the Cincinnati Prehospital Stroke Scale (CPSS), Los Angeles Prehospital Stroke Screen (LAPSS), and Melbourne Ambulance Stroke Scale (MASS) in detecting acute ischemic stroke (AIS) in suspected cases and to compare these scales with each other. Materials and Methods: This diagnostic accuracy study included patients with suspected AIS brought to the emergency department. Patients' data were collected from their medical records. All test data were compared with the final diagnosis of AIS based on the brain magnetic resonance imaging (MRI) report. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were measured separately using statistical tests with confidence interval of 95%. Results: Finally, 766 patients were included, among which 57.6% were male. The mean age of the patients was 66.8 +/- 13.7 years. All patients underwent brain MRI, which showed that 537 (70.1%) patients had an actual diagnosis of AIS. The accuracy rates of CPSS, MASS, and LAPSS were 82.9%, 79.2%, and 78.1%, respectively. In this study, the differences between the sensitivity and specificity of these scales were significant (p<0.001). Conclusion: This study showed that the number of true-positive cases diagnosed by CPSS was higher than that by MASS, and the number of MASS true-positive cases was higher than that of LAPSS. The number of LAPSS true-negative cases was higher than that of MASS, and the number of MASS true-negative cases was higher than that of CPSS.