{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:22:23Z","timestamp":1792790543444,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>The National Institutes of Health Stroke Scale (NIHSS) correlates with presence of large anterior vessel occlusion (LAVO). However, the application of the full NIHSS in the prehospital setting to select patients eligible for treatment with thrombectomy is limited. Therefore, we aimed to evaluate the prognostic value of simple clinical selection strategies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Data from the Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry (January 2012\u2013May 2014) were analyzed retrospectively. Patients with complete breakdown of NIHSS scores and documented vessel status were included. We assessed the association of prehospital stroke scales and NIHSS symptom profiles with LAVO (internal carotid artery, carotid-terminus or M1-segment of the middle cerebral artery).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>Among 3505 patients, 23.6% (n=827) had LAVO. Pathological finding on the NIHSS item best gaze was strongly associated with LAVO (adjusted odds ratio 4.5, 95% confidence interval 3.8\u20135.3). All 3 face\u2013arm\u2013speech\u2013time test (FAST) items identified LAVO with high sensitivity. Addition of the item best gaze to the original FAST score (G-FAST) or high scores on other simplified stroke scales increased specificity. The NIHSS symptom profiles representing total anterior syndromes showed a 10-fold increased likelihood for LAVO compared with a nonspecific clinical profile. If compared with an NIHSS threshold of \u22656, the prehospital stroke scales performed similarly or even better without losing sensitivity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Simple modification of the face\u2013arm\u2013speech\u2013time score or evaluating the NIHSS symptom profile may help to stratify patients\u2019 risk of LAVO and to identify individuals who deserve rapid transfer to comprehensive stroke centers. Prospective validation in the prehospital setting is required.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.116.014431","type":"journal-article","created":{"date-parts":[[2017,1,14]],"date-time":"2017-01-14T03:11:00Z","timestamp":1484363460000},"page":"290-297","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":130,"title":["Clinical Selection Strategies to Identify Ischemic Stroke Patients With Large Anterior Vessel Occlusion"],"prefix":"10.1161","volume":"48","author":[{"given":"Jan F.","family":"Scheitz","sequence":"first","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azmil H.","family":"Abdul-Rahim","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael L.","family":"MacIsaac","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charith","family":"Cooray","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Sucharew","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Kleindorfer","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Khatri","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Broderick","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich J.","family":"Audebert","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niaz","family":"Ahmed","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Wahlgren","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Endres","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian H.","family":"Nolte","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., R.L.M., K.R.L.); Department..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy R.","family":"Lees","sequence":"additional","affiliation":[{"name":"From the Center for Stroke Research Berlin (J.F.S., H.J.A., M.E., C.H.N.), Klinik f\u00fcr Neurologie (J.F.S., H.J.A., M.E., C.H.N.), Excellence Cluster NeuroCure (M.E.), German Center for Cardiovascular Research (DZHK) (M.E.), and German Center for Neurodegenerative Diseases (DZNE) (M.E.), Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Germany; Stroke Research, Institute of Cardiovascular &amp; Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., 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