Prospective Italian Validation of SMS in Patients With Suspected Acute Stroke (PIVA-SMS)

Adult patients presenting to the Emergency Department with suspected acute stroke during the enrollment period.

The final discharge diagnosis will serve as the gold standard.

Inclusion Criteria:

• Age ≥ 18 years at the time of presentation to the Emergency Department.
• Presentation to the Emergency Department with a clinical suspicion of acute stroke, identified at nursing triage and/or through activation of the stroke pathway.
• Presentation to the Emergency Department during the 6-month prospective enrollment period.
• Feasibility of real-time collection of the data required to calculate the Stroke Mimics Score (SMS), including:

age, systolic blood pressure, presence/absence of seizure at onset, presence/absence of headache at onset, presence/absence of confusion at onset, presence/absence of syncope at onset, presence/absence of isolated sensory deficit, presence/absence of motor deficit, history of coronary artery disease, history of prior stroke or transient ischemic attack (TIA).

• Availability of a final hospital discharge diagnosis at the end of hospitalization or Emergency Department observation.
• Signed informed consent from the patient or caregiver. If the patient is unconscious upon arrival at the Emergency Department, deferred consent will be applied.

Exclusion Criteria:

• Age < 18 years.
• Inability to fully collect the data required to calculate the Stroke Mimics Score (SMS).
• Absence of a clearly defined final hospital discharge diagnosis.
• Voluntary discharge, transfer, or death before completion of the diagnostic workup, in the absence of a reliable diagnosis.
• Repeated Emergency Department visits for the same clinical event (only the first visit will be considered).