To assess whether a prehospital Los Angeles motor scale (LAMS) of 4 or more predicts intervention for acute stroke.

Data from all stroke transports to a comprehensive stroke center from January 1, 2018 to October 1, 2018  were abstracted from our IRB approved prehospital research registry. Data abstracted included demographics such as age and gender, prehospital variables such as blood pressure, LAMS and Rankin scores, and outcomes including whether the patient received advanced neuroimaging, intravenous tPA or mechanical thrombectomy (MT) at the receiving facility. 

There were 129 patients who had a LAMS score of 4 or 5, and they were significantly more likely to be an acute ischemic stroke rather than an intracranial hemorrhage or TIA (P<0.0001). The median NIHSS at hospital arrival was 8, with an IQR of 2-16.

Of these 129, 21% received tPA compared to 3% who had a lower LAMS (P<0.0001). Having a LAMS of 4 or 5 was also significantly associated with getting mechanical thrombectomy (36% vs. 12%, P<0.0001), and a higher NIHSS at hospital arrival.  These results retained statistical significance after adjusting for age, gender and field mean arterial pressure (MAP). The median age, IQR and gender was similar between those who had a LAMS or 4 or 5 or less (P=NS).