Prospective Evaluation of the Recognition of Stroke In the Emergency Room (ROSIER) Scale in Emergency Department

ABSTRACT

PURPOSE: Early assessment and rapid intervention in patients with acute stroke can reduce mortality and complication. We conducted a prospective evaluation of the Recognition Of Stroke In the Emergency Room (ROSIER) scale for use in patients with suspected stroke. METHODS: We studied 312 patients with suspected acute stroke who were admitted to the emergency department within 7 months from August 2013 to February 2014. Emergency physicians used the ROSIER scale as a stroke recognition tool, compared with the Face Arm Speech Test (FAST). Patients meeting the inclusion criteria were evaluated for both the FAST and the ROSIER scale and compared with the final discharge diagnoses. Then, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under curve of the FAST, and the ROSIER scale were calculated. RESULTS: The patient group consisted of 141 males and 171 females with an average age of 60 years; 112 (35.9%) patients had ROSIER scale > or =1 indicating a stroke, 98 (31.4%) of these patients had stroke as a final diagnosis. The FAST showed sensitivity of 85.8%, specificity of 92.5%, PPV of 86.6%, and NPV of 92.0%. The ROSIER scale showed relative sensitivity of 86.7%, specificity of 93.0%, PPV of 87.5%, and NPV of 92.5%. CONCLUSION: In this study, the ROSIER scale was a useful stroke recognition tool for potential stroke patients, but showed no significant superiority over the FAST.