Koster et al reported a decision tree based on elemetns from the modified NIHSS. It can help to identify patients with large vessel occlusion who may benefit from thrombectomy. The authors are from multiple institutions in the Netherlands.
GACE = Gaze, facial Asymmetry, level of Consciousness, Extinction/inattention
Patient selection: acute stroke
Outcome: large anterior vessel occlusion (LAVO)
Parameters:
(1) abnormal gaze
(2) facial asymmetry
(3) LOC questions, >= 1 incorrect
(4) LOC commands, >= 1 incorrect
(5) extinction and/or inattention
Gaze
Face
Questions
Commands
Extinction
Node
Yes
Yes
NA
NA
NA
1
Yes
No
NA
NA
NA
2
No
Yes
Yes
Yes
NA
3
No
Yes
Yes
No
NA
4
No
Yes
No
NA
Yes
5
No
Yes
No
NA
No
6
No
No
NA
NA
NA
7
where:
• From 2 to 4 of the 5 parameters are needed to reach a terminal node.
Node
Large Vessel
Not Large Vessel
1
17%
6%
2
1%
3%
3
3%
2%
3
3%
3%
5
3%
2%
6
5%
19%
7
4%
29%
Total
36%
64%
Significant differences are seen in nodes 1, 6 and 7.
Performance:
• The reported area under the ROC was 0.76.
To read more or access our algorithms and calculators, please log in or register.
