Bedside utility of clinical scoring systems in classifying stroke.

BACKGROUND: The study aimed to validate and compare the Siriraj score, Guy's hospital score, Greek score, and Besson score in a group of stroke patients.

MATERIALS AND METHODS: We assessed the stroke scores and compared them to computed tomography (CT) scan of brain.

RESULTS: Two hundred stroke patients (129 ischemic stroke) were included. For ischemic stroke, sensitivity and specificity were 71% and 92% (Siriraj score), 73% and 98% (Greek score), 59% and 87% (Guy's hospital score), and 65% and 98% (Besson score), respectively. For intracranial hemorrhage, sensitivity and specificity were 84% and 89% (Siriraj score), 80% and 99% (Greek score), and 63% and 95% (Guy's hospital score), respectively. Using receptor operating characteristic curve, the greatest area under the curve was obtained for Greek score (0.973). For bedside accurate and safe diagnosis of ischemic stroke, the best cut off was for Greek score (1.5) which identified 47% of ischemic stroke patients.

CONCLUSIONS: The Greek score appears as the single best score. Using the newly developed discriminant cut off value; a substantial number of patients may be started with anti-platelet therapy while awaiting CT scan of brain.