Response by Lima et al to Letter Regarding Article, “Field Assessment Stroke Triage for Emergency Destination: A Simple and Accurate Prehospital Scale to Detect Large Vessel Occlusion Strokes”
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We would like to thank Heldner et al1 for taking an interest on our work and applying the Field Assessment Stroke Triage for Emergency Destination scale (FAST-ED) to their large patient cohort. Triage for stroke centers will undergo major changes given the recently proven benefit of endovascular approaches in the treatment of large vessel occlusion strokes (LVOS). The FAST-ED scale was designed to aid in the decision to triage patients to primary stroke center versus comprehensive stroke centers in the prehospital setting. In STOPStroke (n=727; 33% LVOS), FAST-ED had comparable accuracy to predict LVOS to the National Institutes of Health Stroke Scale score (NIHSS) and higher accuracy than Rapid Arterial Occlusion Evaluation scale (RACE) and Cincinnati Prehospital Stroke Severity Scale (CPSSS) (area under the curve: FAST-ED=0.81 as reference; NIHSS score of =0.80, P=0.28; RACE score of =0.77, P=0.02; and CPSSS score of=0.75, P=0.002).2 Heldner et al1 independently corroborated …