Kurashiki Prehospital Stroke Subtyping Score (KP3S) as a Means of Distinguishing Ischemic from Hemorrhagic Stroke in Emergency Medical Services

Abstract

Background and Purpose: The aim of this study was to devise a new ischemic stroke (IS)/hemorrhagic stroke (HS) stroke score to distinguish IS from HS for emergency medical services (EMS). Materials and Methods: We studied patients with IS and HS who were admitted within 6 h of onset and transferred by the EMS. We compared characteristics of IS and HS to devise a new IS/HS score. Results: A total of 227 patients (median age, 71 years; 139 males; IS, 127 patients; HS, 100 patients) were included in the study. On multivariate analysis following univariate analysis, presence of atrial fibrillation, diastolic blood pressure <100 mm Hg and lack of disturbance of consciousness were independently associated with IS. The following score was devised to distinguish IS from HS in EMS: Kurashiki Prehospital Stroke Subtyping Score (KP3S) = (presence of atrial fibrillation) · 2 + (diastolic blood pressure <100 mm Hg) + (lack of disturbance of consciousness). When KP3S was greater than 1, sensitivity for IS was 64% and specificity 85%. The C statistic of KP3S was 0.805. Conclusion: KP3S is useful for distinguishing IS from HS and for the evaluation of stroke patients by EMS.