RACE v.1
RACE score is a rapid quantitative assessment tool to predict Large Vessel Occlusion (LVO) in patients with acute stroke. It is used in prehospital settings, by EMS providers to predict LVO in stroke patients and decide on transferring the patient to comprehensive stroke units.
The purpose is to calculate the RACE Score and help predict the LVO in acute stroke patients. The main variables used are Facial palsy, Arm motor impairment, Leg motor impairment, Head and gaze deviation, Hemiparesis, Agnosia (left-sided hemiparesis) and Aphasia (right-sided hemiparesis).
The RACE Score is used to do a rapid assessment of an acute stroke patient in the prehospital setting i.e. by EMS providers. This is a quantitative assessment helping to predict the LVO (expressed using sensitivity and specificity of the prediction made). The RACE Score is obtained by adding the points of all variables. Variables 0 1 2 Facial Palsy Normal or Mild Moderate Severe Arm motor Normal or Mild Moderate Severe impairment Leg motor Normal or Mild Moderate Severe impairment Head and Gaze Absent Present Deviation Hemiparesis Left Right Agnosia(left-sided Patient recognizes his/her Does not recognize Does not recognize hemiparesis) arm and impairment his/her arm or his/her arm or impairment impairment Aphasia (right-sided Performs both tasks Performs one task performs neither tasks Hemiparesis) correctly correctly RACE Score interpretation: When RACE Score >=5, LVO is considered and better outcomes can be achieved if transferred to comprehensive stroke centers. RACE Score interpretation: When RACE Score >=5, LVO is considered and better outcomes can be achieved if transferred to comprehensive stroke centers. RACE Score Sensitivity Specificity ≥1 100% 13% ≥2 97% 27% ≥3 93% 40% ≥4 89% 55% ≥5 85% 68% ≥6 72% 77% ≥7 53% 89% ≥8 32% 95% 9 7% 99%
It is a rapid assessment tool to be used in prehospital settings while in hospitals more comprehensive assessment (NIHSS) needs to be carried out. Also, causes for neurological deficit other than LVO, for example, intracerebral hemorrhage, hypoglycemia, etc. need to be ruled out.
1. Pérez de la Ossa Natalia, Carrera David, Gorchs Montse, Querol Marisol, Millán Mònica, Gomis Meritxell, et al. Design and Validation of a Prehospital Stroke Scale to Predict Large Arterial Occlusion. Stroke. 2014 Jan 1;45(1):87–91. 2. Zaidi SF, Shawver J, Morales AE, Salahuddin H, Tietjen G, Lindstrom D, et al. Stroke care: initial data from a county-based bypass protocol for patients with acute stroke. Journal of NeuroInterventional Surgery. 2017 Jul 1;9(7):631–5
OBSERVATION.rapid_arterial_occlusion_evaluation.v0, EVALUATION.rapid_arterial_occlusion_evaluation_score_assessment.v0
