• İbrahim Ulaş Özturan, Duygu Ferek Emir, Adnan Karadaş, Cansu Alyeşil Özturan, Uğur Durmuş, DoğanNurettin ÖzgürNÖDepartment of Emergency Medicine, Istanbul Training and Research Hospital, Istanbul, Turkiye., Elif Yaka, Serkan Yılmaz, and Murat Pekdemir.
• Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, İzmit, Kocaeli, Turkiye. Electronic address: ozturan.iu@gmail.com.
• J Emerg Med. 2024 Aug 8.

BackgroundVision, Aphasia, and Neglect (VAN), Ventura Emergent Large Vessel Occlusion (VES), and Large Artery Intracranial Occlusion (LARIO) are promising stroke screening tools that were shown to have high diagnostic performance to detect Emergent Large Vessel Occlusion (ELVO) in their derivation studies.ObjectivesThis study aimed to assess the validation of VAN, VES, and LARIO in predicting ELVO among patients presenting at emergency department (ED) triage with suspected acute ischemic stroke.MethodsThis is a prospective multicenter study conducted in five EDs of tertiary stroke centers between June and October 2023. Patients with suspected stroke admitted to ED for triage were evaluated using the VAN, VES, and LARIO stroke screening tools. Diagnostic performances of these tools for predicting ELVO were determined and compared with the National Institute of Health Stroke Scale (NIHSS).ResultsA total of 614 patients were included. The prevalence of ELVO was found to be 23.5% in the study population. VAN exhibited a sensitivity of 70.1% and specificity of 78.7%, VES showed a higher sensitivity (79.1%) with lower specificity (63.4%), while LARIO displayed high specificity (86%) with lower sensitivity (56.3%). Receiver operating characteristic curve analysis showed that LARIO and NIHSS had similar diagnostic performance (areas under the curve [AUC] 0.801 and 0.805, p = 0.7, respectively), while VES showed a modestly poorer performance (AUC 0.746, p < 0.001 and p = 0.003).ConclusionThe comparable diagnostic performance of VAN, VES, and LARIO to the NIHSS, in addition to their straightforwardness and rapid evaluation time, can facilitate optimal care for patients with ELVO in prehospital or ED triage settings.Copyright © 2024 Elsevier Inc. All rights reserved.

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