Abstract Details

Title SALVO- Speedy Detection of Large Vessel Occlusion - Ischemic Stroke in Hyper Acute Setting

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-045

Objective The objective is to validate a new simplistic stroke scale, Sinai Assessment for Large Vessel Occlusion (SALVO).

Background Several stroke severity scales have been developed but are often complex or have low sensitivity and/or specificity. Early detection of large vessel occlusions can decrease time to intervention.

Design/Methods Based on literature review we developed a 4-item stroke scale evaluating: 1) level of consciousness; 2) gaze palsy/deviation; 3) speech; and 4) motor functions. Each item is graded from 0 to 2: 0 indicative of normal findings, 1 mild findings and 2 severe findings. A retrospective study was performed in two hospitals, Mount Sinai - 319 bed hospital and Holy Cross - 264 bed hospital between 10/01/2016 - 01/18/2018. Initial cohort of 1059 patients included all patients whom a “Code Stroke” was initiated. Due to cancelled codes, hemorrhagic strokes, or lack of information in electronic medical records, 543 patients were excluded from the analysis. Demographic and stroke-related data (e.g. NIH stroke scale (NIHSS), MRI/CTA findings, thrombolysis etc) were collected and analyzed. A SALVO score was retrospectively assigned based on clinical documentation. For statistical analysis, Stata SE 10.0 and Minitab 18 were used.

Results Among 518 patients included analyzed, 92 (17.8%) had a confirmed LVO whereas 426 (82.2%) did not. Only 368 patients (71%) had the NIHSS available in their charts. A statistically significant correlation was observed between SALVO and NIHSS (p<0.001) as well as a statistically significant relationship (r=0.82). A SALVO score ≥3 has sensitivity of 77%, specificity of 92%, positive predictive value of 67%, and negative predictive value of 95%.

Conclusions The SALVO score has promising accuracy in prediction of LVO in hyper-acute setting. A prospective study would be beneficial to compare it to other stroke severity scale and determine inter-rater reliability between emergency medical service personnel, emergency department nurses, and emergency medicine physicians.

Authors/Disclosures
PRESENTER	No disclosure on file
Heather Beckstrom (MetroSouth)	No disclosure on file
Natasha Rai, MD (South Lake Hospital)	No disclosure on file
Sai Prada Kunkala	No disclosure on file
	No disclosure on file
	No disclosure on file
Deepa Bhupali, MD (Home)	Dr. Bhupali has nothing to disclose.

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