Inter-rater reliability between paramedics and neurologists in the assessment of severe hemiparesis in acute stroke

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F19%3AA2002463" target="_blank" >RIV/61988987:17110/19:A2002463 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/19:00112628 RIV/00843989:_____/19:E0107885 RIV/00159816:_____/19:00072520

Výsledek na webu

<a href="https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2019-4-4/inter-rater-reliability-between-paramedics-and-neurologists-in-the-assessment-of-severe-hemiparesis-in-acute-stroke-113226/download?hl=en" target="_blank" >https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2019-4-4/inter-rater-reliability-between-paramedics-and-neurologists-in-the-assessment-of-severe-hemiparesis-in-acute-stroke-113226/download?hl=en</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.14735/amcsnn2019391" target="_blank" >10.14735/amcsnn2019391</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Inter-rater reliability between paramedics and neurologists in the assessment of severe hemiparesis in acute stroke

Popis výsledku v původním jazyce

Aim: Pre-hospital triage by paramedics could determine which patients qualify for direct transport to comprehensive stroke centres for mechanical thrombectomy. For triage to be successful, paramedics have to be able to identify major neurological impairments. The aim of our study was to determine inter-rater reliability between paramedics and stroke neurologists in identifying severe hemiparesis in acute stroke pat lents. Methods: In this prospective, multicentre study, 225 paramedics from Emergency Medical Services were taught via e-learning to distinguish between mild and severe hemiparesis. Inter-rater agreement between paramedics and stroke specialists in evaluating the degree of hemiparesis (National Institutes of Health Stroke Scale [NIHSS], items 5 and 6, scoring 0-2 [none or mild] vs. 3-4 [severe]) was assessed using the unweighted K index. Results: Over the course of 10 months in 2016, 402 consecutive patients (average age 75 years) were evaluated for the presence of hemiparesis by paramedics during pre-hospital care and by stroke neurologists immediately after stroke centre admission. The total agreement between the paramedics and neurologists in their evaluations of severe hemiparesis or monoparesis was moderate: K 0.43 (95% Cl 0.36-0.50). Conclusion: We found moderate reproducibility of the identification of severe hemiparesis in acute stroke patients when assessed by paramedics in a pre-hospital setting. Better education for paramedics is needed before implementing a change in transport triage based on their assessment of severity of neurological deficit.

Název v anglickém jazyce

Inter-rater reliability between paramedics and neurologists in the assessment of severe hemiparesis in acute stroke

Popis výsledku anglicky

Aim: Pre-hospital triage by paramedics could determine which patients qualify for direct transport to comprehensive stroke centres for mechanical thrombectomy. For triage to be successful, paramedics have to be able to identify major neurological impairments. The aim of our study was to determine inter-rater reliability between paramedics and stroke neurologists in identifying severe hemiparesis in acute stroke pat lents. Methods: In this prospective, multicentre study, 225 paramedics from Emergency Medical Services were taught via e-learning to distinguish between mild and severe hemiparesis. Inter-rater agreement between paramedics and stroke specialists in evaluating the degree of hemiparesis (National Institutes of Health Stroke Scale [NIHSS], items 5 and 6, scoring 0-2 [none or mild] vs. 3-4 [severe]) was assessed using the unweighted K index. Results: Over the course of 10 months in 2016, 402 consecutive patients (average age 75 years) were evaluated for the presence of hemiparesis by paramedics during pre-hospital care and by stroke neurologists immediately after stroke centre admission. The total agreement between the paramedics and neurologists in their evaluations of severe hemiparesis or monoparesis was moderate: K 0.43 (95% Cl 0.36-0.50). Conclusion: We found moderate reproducibility of the identification of severe hemiparesis in acute stroke patients when assessed by paramedics in a pre-hospital setting. Better education for paramedics is needed before implementing a change in transport triage based on their assessment of severity of neurological deficit.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

CESKA A SLOVENSKA NEUROLOGIE A NEUROCHIRURGIE

ISSN

1210-7859

e-ISSN

1802-4041

Svazek periodika

82

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

4

Strana od-do

391-395

Kód UT WoS článku

000500970200007

EID výsledku v databázi Scopus

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