Chang et al reported the 2CAN score for identifying a stroke occurring in an inpatient. The authors are from Northwestern University.
Patient selection: inpatient not admitted for stroke
Parameters:
(1) clinical deficit score (CDS)
(2) recent cardiac procedure during hospitalization (C)
(3) history of atrial fibrillation (A)
(4) time since admission in hours ("new", N)
Clinical deficit score components:
(1) facial droop on one side (NIHSS item 4)
(2) one arm does not move or is weaker (NIHSS item 5)
(3) slurred, inappropriate words or mute (NIHSS items 1, 9 or 10)
|
Parameter
|
Finding
|
Points
|
|
clinical deficit score
|
0
|
0
|
|
|
1
|
1
|
|
|
2 or 3
|
3
|
|
recent cardiac procedure
|
no
|
0
|
|
|
yes
|
1
|
|
atrial fibrillation
|
no
|
0
|
|
|
yes
|
1
|
|
time since admission
|
< 24 hours
|
1
|
|
|
>= 24 hours
|
0
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score >=2 had a sensitivity of 92% and specificity of 70% for inpatient stroke.
Performance:
• The area under the ROC curve was 0.88.
