TY - JOUR T1 - Revalidation of the RACE scale after its regional implementation in Catalonia: a triage tool for large vessel occlusion JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 751 LP - 756 DO - 10.1136/neurintsurg-2018-014519 VL - 11 IS - 8 AU - David Carrera AU - Montse Gorchs AU - Marisol Querol AU - Sònia Abilleira AU - Marc Ribó AU - Mònica Millán AU - Anna Ramos AU - Pedro Cardona AU - Xabier Urra AU - Ana Rodríguez-Campello AU - Luis Prats-Sánchez AU - Francisco Purroy AU - Joaquín Serena AU - David Cánovas AU - Josep Zaragoza-Brunet AU - Jerzy A Krupinski AU - Xavier Ustrell AU - Júlia Saura AU - Sonia García AU - Maria Àngela Mora AU - Xavier Jiménez AU - Antoni Dávalos AU - Natalia Pérez de la Ossa A2 - , Y1 - 2019/08/01 UR - http://jnis.bmj.com/content/11/8/751.abstract N2 - Background and purpose Our aim was to revalidate the RACE scale, a prehospital tool that aims to identify patients with large vessel occlusion (LVO), after its region-wide implementation in Catalonia, and to analyze geographical differences in access to endovascular treatment (EVT).Methods We used data from the prospective CICAT registry (Stroke Code Catalan registry) that includes all stroke code activations. The RACE score evaluated by emergency medical services, time metrics, final diagnosis, presence of LVO, and type of revascularization treatment were registered. Sensitivity, specificity, and area under the curve (AUC) for the RACE cut-off value ≥5 for identification of both LVO and eligibility for EVT were calculated. We compared the rate of EVT and time to EVT of patients transferred from referral centers compared with those directly presenting to comprehensive stroke centers (CSC).Results The RACE scale was evaluated in the field in 1822 patients, showing a strong correlation with the subsequent in-hospital evaluation of the National Institute of Health Stroke Scale evaluated at hospital (r=0.74, P<0.001). A RACE score ≥5 detected LVO with a sensitivity 0.84 and specificity 0.60 (AUC 0.77). Patients with RACE ≥5 harbored a LVO and received EVT more frequently than RACE <5 patients (LVO 35% vs 6%; EVT 20% vs 6%; all P<0.001). Direct admission at a CSC was independently associated with higher odds of receiving EVT compared with admission at a referral center (OR 2.40; 95% CI 1.66 to 3.46), and symtoms onset to groin puncture was 133 min shorter.Conclusions This large validation study confirms RACE accuracy to identify stroke patients eligible for EVT, and provides evidence of geographical imbalances in the access to EVT to the detriment of patients located in remote areas. ER -