Abstract Details

Title Novel Weighted FANG-D Scoring to Determine Large Vessel Occlusion

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-027

Objective To determine if a novel weighted scoring of FANG-D scale increases sensitivity and specificity rates of large vessel occlusion (LVO) as compared to those with original FANG-D scale scoring.

Background Scales have been developed to detect the severity of strokes based on symptomology. The FANG-D was created and can be completed in one minute. Results from a 2020 study lacked high specificity results. Upon review, it was determined that the severity of symptoms needed to be considered before awarding points indicating positive FANG-D.

Design/Methods An observational, descriptive design was used to identify field cut, aphasia, neglect, gaze preference, and dense hemiparesis in patients admitted to the ED of a comprehensive stroke center from December 2022 through April 2023. The NIHSS was compared with the novel weighted FANG-D scale scoring for analysis. Each component was required to have a score ≥ 2 (moderate to severe deficits) except dense hemiparesis which required a score ≥3 (significant weakness) to receive one point on the FANG-D scale. A total score of 2 or higher on FANG-D indicated a positive result suggesting LVO. If aphasia or neglect were present with a NIHSS of ≥2, it was considered a positive FANG-D score.

Results 311 patients were included. The sensitivity and specificity rates were 85.7% and 90.5% respectively for positive FANG-D to identify LVO. The previous FANG-D study group used lower values in calculating the FANG-D scores and reported a sensitivity rate of 98% and specificity of 76.7%.

Conclusions The novel weighted FANG-D has high specificity and is reliable for LVO prediction. This scale scoring method could be tested in the prehospital setting. The use of a scale with higher specificity for LVO could improve patient outcomes and resource utilization by faster routing of patients to CSCs capable of performing mechanical thrombectomy.

Authors/Disclosures
Suzanne Crandall, DO (Charleston Area Medical Center) PRESENTER	Dr. Crandall has nothing to disclose.
Lauren Seeberger, MD, FAAN	Dr. Seeberger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocine Biosciences. Dr. Seeberger has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Seeberger has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurocrine Biosciences. The institution of Dr. Seeberger has received research support from Neurocrine. The institution of Dr. Seeberger has received research support from TEVA.

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