Uchida et al reported the Japan Urgent Stroke Triage (JUST) score to aid in the prehospital triage of a patient who may have a stroke. The authors are from multiple institutions in Japan.
Patient selection: prehospital triage of a patient suspected of having a stroke
Outcomes: any stroke, large vessel obstruction (LVO), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH)
Number of items: 21
|
Parameter |
Any Stroke |
LVO |
ICH |
SAH |
|
age >= 75 years |
|
|
|
-2 |
|
smoking |
2 |
|
|
2 |
|
history of cerebral infarct |
|
|
-2 |
|
|
sudden onset |
|
1 |
|
|
|
improved after onset |
|
|
-2 |
|
|
progressed after onset |
1 |
|
1 |
|
|
headache |
1 |
-3 |
1 |
4 |
|
aphasia |
1 |
|
|
|
|
convulsion |
-1 |
|
|
|
|
dysarthria |
1 |
|
2 |
-2 |
|
dizziness |
|
|
|
-2 |
|
nausea and/or vomiting |
|
|
|
1 |
|
systolic BP >= 165 mm Hg |
1 |
|
1 |
|
|
diastolic BP >= 95 mm Hg |
|
|
1 |
|
|
cardiac arrhythmia |
1 |
2 |
-2 |
|
|
disturbed consciousness |
|
1 |
1 |
2 |
|
conjugate deviation (eyes) |
1 |
|
1 |
|
|
unilateral spatial neglect |
|
1 |
|
|
|
facial palsy |
1 |
1 |
|
|
|
upper limb paralysis |
1 |
3 |
2 |
|
|
lower limb paralysis |
|
|
|
-2 |
score for any stroke =
= SUM(points for all 11 scored items)
score for large vessel obstruction =
= SUM(points for all 7 scored items)
score for intracerebral hemorrhage =
= SUM(points for all 10 scored items)
score for subarachnoid hemorrhage =
= SUM(points for all 8 scored items)
Interpretation:
• minimum score for any stroke: -1
• maximum score for any stroke: 11
• minimum score for LVO: -3
• maximum score for LVO: 9
• minimum score for ICH: -6
• maximum score for ICH: 10
• minimum score for SAH: -8
• maximum score for SAH: 9
|
Any Stroke |
Percent |
|
-1 or 0 |
14% |
|
1 |
36% |
|
2 |
61% |
|
3 |
71% |
|
4 to 9 |
88% |
|
LVO |
Percent |
|
-3 or -1 |
0% |
|
0 to 3 |
4% |
|
4 to 6 |
18% |
|
7 |
49% |
|
8 or 9 |
79% |
|
ICH |
Percent |
|
-6 to -2 |
3% |
|
-1 to 2 |
8% |
|
3 or 4 |
24% |
|
5 or 6 |
42% |
|
7 to 9 |
65% |
|
SAH |
Percent |
|
-8 or -3 |
0% |
|
-2 to 2 |
1% |
|
3 or 4 |
10% |
|
5 or 6 |
30% |
|
7 to 9 |
90% |
Performance:
• The are under the ROC curve was 0.85.
Specialty: Neurology, Emergency Medicine
