title: The kurashiki prehospital stroke scale is a prehospital scale that can predict long-term outcome of patients with acute cerebral ischemia.
abstract: OBJECTIVE
  Our aim was to confirm the clinical relationship between the Kurashiki Prehospital Stroke Scale (KPSS) scored by paramedics and favorable outcomes in patients with modified Rankin scale (mRS) scores of 0-1 assessed 3 months after symptom onset.
  
  
  METHODS
  We enrolled patients with acute stroke and transient ischemic attack showing symptoms on admission. Paramedics transferred patients to our hospital after estimating stroke severity using the KPSS. After categorizing patients into either the mRS 0-1 group (favorable outcome) or the mRS 2-6 group (no favorable outcome), we compared the background data between the two groups. We assessed KPSS scores predictive of a favorable outcome. Multivariate regression modeling was conducted to identify factors independently associated with a favorable outcome.
  
  
  RESULTS
  The study cohort comprised 147 patients with a premorbid status of mRS 0-1: 69 patients (47%) of them were in the mRS 0-1 group and 78 (53%) in the mRS 2-6 group at the follow-up 3 months after symptom onset. The median KPSS score was lower in the mRS 0-1 group than in the mRS 2-6 group (1 vs. 4, p < 0.001). After classifying the 147 patients into KPSS tertiles with thresholds of 2 and 4, the frequency of mRS 0-1 gradually decreased with increasing KPSS score (lower KPSS, 67.2%; middle KPSS, 47.6%, and higher KPSS, 21.3%; p < 0.001). KPSS score <3 was able to predict a favorable outcome with 67% sensitivity and 71% specificity, and independently associated with mRS 0-1 (odds ratio, 3.0; 95% confidence interval, 1.2-7.3; p = 0.015).
  
  
  CONCLUSIONS
  KPSS score <3 apparently presents a reasonable cutoff for predicting a favorable outcome in patients with acute cerebral ischemia.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sakai
authors.forename: Shuichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Junichi
authors.initials: J
authors.lastname: Uemura