title: Validation of Siriraj Stroke Score in southeast Nigeria.
abstract: The aim of the study is to validate the use of Siriraj Stroke Score (SSS) in the diagnosis of acute hemorrhagic and acute ischemic stroke in southeast Nigeria. This was a prospective study on validity of SSS in the diagnosis of stroke types in southeast Nigeria. Subjects diagnosed with stroke for whom brain computerized tomography (CT) scan was performed on admission were recruited during the study period. SSS was calculated for each subject, and the SSS diagnosis was compared with brain CT scan-based diagnosis. A total of 2,307 patients were admitted in the hospital medical wards during the study period, of whom 360 (15.6%) were stroke patients and of these, 113 (31.4%) adult subjects met the inclusion criteria. The mean age of the subjects was 66.5±2.6 years. The mean interval between ictus and presentation was 2.5±0.4 days. Ischemic stroke was confirmed by CT in 74 subjects; however, SSS predicted 60 (81.1%) of these subjects correctly (P<0.05). Hemorrhagic stroke was confirmed by CT in 39 subjects, and SSS predicted 36 (92.3%) of them correctly (P<0.05). In acute ischemic stroke, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SSS were 92%, 94%, 97%, 86%, and 93%, respectively, while in patients with hemorrhagic stroke, the corresponding percentages were 94%, 92%, 86%, 97%, and 93%, respectively. SSS is not reliable enough to clinically differentiate stroke types in southeast Nigeria to warrant interventions like thrombolysis in acute ischemic stroke.
authors.affiliation: Division of Nephrology, Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Innocent Ijezie
authors.initials: II
authors.lastname: Chukwuonye
authors.affiliation: Division of Neurology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Kenneth Arinze
authors.initials: KA
authors.lastname: Ohagwu
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria ; Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Enoch Ogbonnaya
authors.initials: EO
authors.lastname: Uche
authors.affiliation: Department of Ophthalmology, Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Abali
authors.initials: A
authors.lastname: Chuku
authors.affiliation: Division of Neurology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Rowland Ihezuo
authors.initials: RI
authors.lastname: Nwanke
authors.affiliation: Department of Radiography, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
authors.forename: Christopher Chukwuemeka
authors.initials: CC
authors.lastname: Ohagwu
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Ignatius U
authors.initials: IU
authors.lastname: Ezeani
authors.affiliation: Department of Hematology, Federal Medical Centre, Umuahia, Nigeria.
authors.forename: Collins Ogbonna
authors.initials: CO
authors.lastname: Nwabuko
authors.affiliation: Department of Anatomical Pathology, University of Calabar, Calabar, Nigeria.
authors.forename: Martin Anazodo
authors.initials: MA
authors.lastname: Nnoli
authors.affiliation: Federal Medical Centre, Umuahia, Nigeria ; Division of Nephrology, Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.
authors.forename: Efosa
authors.initials: E
authors.lastname: Oviasu
authors.affiliation: Federal Medical Centre, Umuahia, Nigeria ; Division of Cardiology, University College Hospital Ibadan, Ibadan, Nigeria.
authors.forename: Okechukwu Samuel
authors.initials: OS
authors.lastname: Ogah
keywords: CT scan; Siriraj Stroke Score (SSS); acute ischemic stroke; hemorrhagic stroke; stroke