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Recognition of Stroke in the Emergency Room - ROSIER Scale

Purpose: To evaluate a patient who may be having a stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale.

Description

The Recognition of Stroke in the Emergency Department (ROSIER) scale can be used to separate patients with stroke from those with a condition that may mimic a stroke. This can improve referrals to a stroke team. The authors are from the Freeman Stroke Service and Newcastle Hospitals NHS Trust in England.


 

Parameters:

(1) loss of consciousness or syncope

(2) seizure activity

(3) asymmetric facial weakness

(4) asymmetric arm weakness

(5) asymmetric leg weakness

(6) speech disturbance

(7) visual field defect

 

Parameter

Finding

Points

loss of consciousness or syncope

no

0

 

yes

-1

seizure activity

no

0

 

yes

-1

asymmetric facial weakness

no

0

 

yes

1

asymmetric arm weakness

no

0

 

yes

1

asymmetric leg weakness

no

0

 

yes

1

speech disturbance

no

0

 

yes

1

visual field defect

no

0

 

yes

1

 

total scale =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: -2

• maximum score: 5

• A score >= 1 is associated with stroke.

 

Performance:

• The sensitivity is 92% and specificity 86%.

• The positive predictive value is 88% and negative predictive value 91%.

 


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Specialty

Objective

ICD-10