Stroke Cincinnati Prehospital Stroke Severity Scale Evaluation iN prEhospital (SCENE)

Evaluation of the Performances of the Cincinnati Prehospital Stroke Severity Scale Realized During Telephone Call With Emergency Department Physicians to Predict Large-vessel Occlusion

The effectiveness of acute ischemic stroke (AIS) management has improved considerably in recent years with thrombolysis and more recently with mechanical thrombectomy (MT). Currently, mechanical thrombectomy can only be performed in stroke unit with an interventional neuroradiology center by experienced/qualified interventional neuroradiologists. In the Rhone area, only one hospital has the authorization to perform mechanical thrombectomy. Therefore, transferring directly eligible acute ischemic stroke patients for mechanical thrombectomy to this center constitutes an important stake of the triage of suspected acute ischemic stroke patients. Some validated scores for the identification of severe strokes and large vessel occlusion, including the Cincinnati prehospital stroke severity scale (CPSSS), appear to be relevant for pre-hospital use in order to identify patients potentially eligible for mechanical thrombectomy and address them to a stoke unit with interventional radiology center.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Diagnostic test: Questionnaire

• Study Type: Observational
• Enrollment (Actual): 1272

Contacts and Locations

Study Locations

• France
  • Bron, France
    • Neurologie, Hôpital Neurologique - HCL
  • Lyon, France, 69003
    • SAMU 69 , Hôpital Edouard Herriot
  • Lyon, France
    • Médecine d'urgence, Clinique de la Sauvegarde
  • Lyon, France
    • Médecine d'urgence, Hôpital de la Croix-Rousse - HCL
  • Lyon, France
    • Médecine d'urgence, Hôpital Desgenettes
  • Lyon, France
    • Médecine d'urgence, Hôpital Mutualiste Médipôle
  • Lyon, France
    • Médecine d'urgence, Hôpital Saint Joseph Saint Luc
  • Pierre-Bénite, France
    • Urgentiste, Centre Hospitalier Lyon Sud
  • Roanne, France
    • Médecine d'urgence, CH de Roanne
  • Tarare, France
    • Médecine d'urgence, Hôpital Nord-Ouest
  • Vienne, France
    • Services Médecine d'urgence et Neurologie, CH de Vienne
  • Villefranche-sur-Saône, France
    • Services Neurologie et Médecine d'urgence, CH de Villefranche sur Saône

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with stroke of the Rhone area after emergency medical services call

Description

Inclusion Criteria:

• Consecutive patients calling emergency medical services for suspected acute ischemic stroke

Exclusion Criteria:

• Symptom onset (or the last time the patient was seen without deficit ) of more than 6 hours

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Patients with suspected ischemic stroke; The cohort will be constituted of patients treated for a stroke suspicion after calling emergency medical services of the Rhone and presenting a symptom-onset (the last time the patient was seen without deficit) less than 6 hours.

Diagnostic test: Questionnaire; Tests from Cincinnati prehospital stroke severity scale (CPSSS) will be carried out by the physician at emergency medical services on telephone call with firemen, paramedics or the emergency medical services team for any stroke suspicion that meets the criteria for inclusion. Emergency department physician will have to follow a standardized questionnaire to complete the different items of the score. The score will not be calculated by emergency department physician and will not influence the orientation and management of patients. The final diagnosis will be the presence or absence of a large vessel occlusion. This diagnosis will be done on cerebral imaging by a neurologist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performances of Cincinnati prehospital stroke severity scale	The Cincinnati prehospital stroke severity scale is composed of 3 items: 2 points if the patient has a deviation of the gaze, 1 point if the patient is not able to give the date and answer to a simple order such as closing the eyes or clenching the fist and 1 point if the patient presents a hemiplegia. The CPSSS score ranges from 0 to 4, highest value indicating the worst score. It will be considered positive if it is equal to 2 or more. Performances will be evaluated in terms of sensitivity, specificity, positive and negative predictive values.	1 day

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon

Study record dates

Study Major Dates

• Study Start (Actual): June 25, 2018
• Primary Completion (Actual): January 31, 2022
• Study Completion (Actual): January 31, 2022

Study Registration Dates

• First Submitted: June 7, 2017
• First Submitted That Met QC Criteria: June 7, 2017
• First Posted (Actual): June 8, 2017

Study Record Updates

• Last Update Posted (Actual): November 21, 2022
• Last Update Submitted That Met QC Criteria: November 18, 2022
• Last Verified: November 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: 69HCL17_0146

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No