Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE

Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0...

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Veröffentlicht in:Stroke (1970) 2024-09, Vol.55 (9), p.2240-2246
Hauptverfasser: Turón-Viñas, Eulàlia, Boronat, Susana, Gich, Ignasi, González Álvarez, Verónica, García-Puig, Montserrat, Camós Carreras, Maria, Rodriguez-Palmero, Agustí, Felipe-Rucián, Ana, Aznar-Laín, Gemma, Jiménez-Fàbrega, Xavier, Pérez de la Ossa, Natalia
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container_end_page 2246
container_issue 9
container_start_page 2240
container_title Stroke (1970)
container_volume 55
creator Turón-Viñas, Eulàlia
Boronat, Susana
Gich, Ignasi
González Álvarez, Verónica
García-Puig, Montserrat
Camós Carreras, Maria
Rodriguez-Palmero, Agustí
Felipe-Rucián, Ana
Aznar-Laín, Gemma
Jiménez-Fàbrega, Xavier
Pérez de la Ossa, Natalia
description Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0-2; arm motor function 0-2; leg motor function 0-2; head/gaze deviation 0-1; and aphasia or agnosia 0-2), has good sensitivity and specificity in detecting large vessel occlusion. We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability. The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852;
doi_str_mv 10.1161/STROKEAHA.124.046846
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A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0-2; arm motor function 0-2; leg motor function 0-2; head/gaze deviation 0-1; and aphasia or agnosia 0-2), has good sensitivity and specificity in detecting large vessel occlusion. We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability. The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852; &lt;0.001) and prehospital/emergency staff (Spearman ρ, 0.781; &lt;0.001). The median Pediatric RACE score was significantly higher in patients with large vessel occlusion (6.5; interquartile range, 6-7) than with other etiologies. 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title Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE
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