Clinical signs in young patients with stroke related to FAST: results of the sifap1 study.
OBJECTIVE
The present study aimed to evaluate the frequency of warning signs in younger patients with stroke with a special regard to the 'FAST' scheme, a public stroke recognition instrument (face, arm, speech, timely).


METHODS
Primary stroke care in participating centres of a multinational European prospective cross-sectional study (Stroke in Young Fabry Patients; sifap1). Forty-seven centres from 15 European countries participate in sifap1.


METHODS
5023 acute patients with stroke (aged 18-55 years) patients (96.5% Caucasians) were enrolled in the study between April 2007 and January 2010.


METHODS
sifap1 was originally designed to investigate the relation of juvenile stroke and Fabry disease. A secondary aim of sifap1 was to investigate stroke patterns in this specific group of patients. The present investigation is a secondary analysis addressing stroke presenting symptoms with a special regard to signs included in the FAST scheme.


RESULTS
4535 patients with transient ischaemic attack (TIA; n=1071), ischaemic stroke (n=3396) or other (n=68) were considered in the presented analysis. FAST symptoms could be traced in 76.5% of all cases. 35% of those with at least one FAST symptom had all three symptoms. At least one FAST symptom could be recognised in 69.1% of 18-24 years-old patients, in 74% of those aged 25-34 years, in 75.4% of those aged 35-44 years, and 77.8% in 45-55 years-old patients. With increasing stroke severity signs included in the FAST scheme were more prevalent (National Institute of Health Stroke Scale, NIHSS<5: 69%, NIHSS 6-15: 98.9%, NIHSS>15: 100%). Clustering clinical signs according to FAST lower percentages of strokes in the posterior circulation (65.2%) and in patients with TIA (62.3%) were identified.


CONCLUSIONS
FAST may be applied as a useful and rapid tool to identify stroke symptoms in young individuals aged 18-55 years. Especially in patients eligible for thrombolysis FAST might address the majority of individuals.


BACKGROUND
The study was registered in http://www.clinicaltrials.gov (No. NCT00414583).
Department of Neurology, Justus Liebig University, Giessen, Germany.
Manfred
M
Kaps
Department of Biostatistics and Clinical Epidemiology, Charité- University Medicine Berlin, Berlin, Germany.
Ulrike
U
Grittner
Department of Neurology, Charité, Berlin, Germany.
Gerhard
G
Jungehülsing
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Turgut
T
Tatlisumak
Department of Neurology, Moritz Arndt University Greifswald, Greifswald, Germany.
Christoph
C
Kessler
Department of Neurology, University of Graz, Graz, Austria.
Reinhold
R
Schmidt
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Putaala
P
Jukka
Department of Neurology, Lund, Sweden.
Bo
B
Norrving
Albrecht-Kossel Institute for Neuroregeneration, University of Rostock, Rostock, Germany.
Arndt
A
Rolfs
Department of Neurology, Justus Liebig University, Giessen, Germany.
Christian
C
Tanislav
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis*; D063189:Symptom Assessment / Q000379:methods*; D055815:Young Adult
EPIDEMIOLOGY; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; MEDICAL EDUCATION & TRAINING; NEUROLOGY