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Master Thesis

Élaboration du Quick-NIHSS (National Institutes of Health Stroke Scale) : un score simple et rapide pour le triage préhospitalier des suspicions d’AVC

Abstract : Stroke is the second leading cause of morbidity in the world and remains a public health challenge despite current technological advances. As has already been widely demonstrated, the sooner the relevant therapies are implemented, the more effective they are. Several scores exist with their specific advantages. The diagnostic, prognostic and therapeutic reference score is NIHSS, because of its reliability and reproducibility. But it is essentially suitable for use in hospitals, by specialized personnel. The present work proposes to simplify it for prehospital use. The three goals we set ourselves were, firstly, to be easier to evaluate than the NIHSS, secondly to use more widely and thirdly to have good inter-observer reproducibility. To validate the relevance of this score, we extracted in the medical file all the first NIHSS performed by a neurologist for patients with suspected stroke admitted to the emergency department of Bordeaux between 2015 and 2017. We were able to create a database consisting of the type of stroke (ischemic, AIT or haemorrhagic) and associated treatment. The use of the most statistically significant variables made it possible to construct a score composed of 5 binary variables. This allows us to construct a score, the QNIHSS, with an air under the ROC curve equivalent to that of the NIHSS, and an absence of patient loss to thrombectomy (compared to the NIHSS). Finally, the QNIHSS with a diagnostic threshold set at 1, had a sensitivity of 0.901 and a specificity of 0.387 to identify patients eligible for thrombectomy, and therefore meets our desire to better sort the patients suspected of having a pre-hospital stroke.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02496175
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, March 2, 2020 - 5:48:55 PM
Last modification on : Tuesday, March 17, 2020 - 1:14:08 AM

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Andy Geiser. Élaboration du Quick-NIHSS (National Institutes of Health Stroke Scale) : un score simple et rapide pour le triage préhospitalier des suspicions d’AVC. Médecine humaine et pathologie. 2019. ⟨dumas-02496175⟩

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