Fast-track medical care system in hyperacute stage stroke using prehospital stroke scale TOPSPIN: TOYOTA prehospital stroke scale for t-PA intravenous therapy

裕丈, 辻; 直英, 近藤; 卓, 西田; 淳一郎, 鈴木; 武司, 安田; 泰広, 伊藤

doi:10.3995/jstroke.30.643

Cited by 4 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We developed the TOPSPIN based on discussions with the EMS of Toyota city (4 fire departments and 11 branch offices, including 63 EMS crews, 435 fire station staffs and 20 ambulances, and multiple revisions [12]. The TOPSPIN consists of 5 items each scored from 0 to 10 points: consciousness, atrial fibrillation, language disorder, hemiparesis of the upper extremities, and hemiparesis of the lower extremities ( Table 1).…”

Section: Toyota Prehospital Stroke Scale For T-pa Intravenous Therapymentioning

confidence: 99%

“…We devised a prehospital stroke scale, the TOYOTA prehospital stroke scale for t-PA intravenous therapy (TOPSPIN), which includes an assessment of atrial fibrillation, as triage for patients with ischemic stroke and especial indications for intravenous t-PA therapy [12]. We included the evaluation of atrial fibrillation because atrial fibrillation is present, which is an independent risk factor for cerebral infarction [13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ten-Year Evaluation of the TOYOTA Prehospital Stroke Scale for Tissue Plasminogen Activator Intravenous Therapy in the Real World

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background: Emergency medical services are an important part of acute stroke management. We devised a prehospital stroke scale, the TOYOTA prehospital stroke scale for tissue plasminogen activator (t-PA) intravenous therapy (TOPSPIN) for triaging patients with ischemic stroke and especial indications for intravenous t-PA therapy in December 2006; this scale comprises 5 items including consciousness, atrial fibrillation, language disorder, disturbance of the upper extremities, and disturbance of the lower extremities. The aim of this study was to analyze the results of 10 years of TOPSPIN implementation and to distinguish ischemic stroke from hemorrhagic stroke in the real world. Methods: We prospectively enrolled consecutive patients who were transferred to our hospital and evaluated by Toyota city ambulance services using the TOPSPIN from December 2006 to January 2017. We examined definite diagnosis at the time of hospital discharge (ischemic stroke, hemorrhagic stroke, or stroke mimic), positive-predictive value of the stroke, the rate of the recanalization therapy, and clinical differentiation among patients with hemorrhagic stroke, ischemic stroke, and stroke mimics. Results: A total of 1,482 consecutive patients were enrolled; 1,134 (76.5%) were patients with stroke (628 ischemic-type, 34 transient ischemic attack-type, and 472 hemorrhagic-type) and 348 (23.5%) without stroke (80 with seizure, 42 with syncope, 27 with hypoglycemia, and 199 other). Among 628 patients with ischemic stroke, 130 (20.7%) received intravenous recombinant t-PA treatment, endovascular therapy, or both. The presence of atrial fibrillation, older age, lower blood pressure, and lower total TOPSPIN score was more commonly associated with ischemic stroke than with hemorrhagic stroke. In multivariable logistic regression analysis, the presence of atrial fibrillation was independently associated with ischemic stroke (OR 2.33; 95% CI 1.61–3.40). Conclusions: The TOPSPIN is a simple prehospital stroke scale that includes an assessment of atrial fibrillation. Detection of atrial fibrillation in the prehospital stage may point to a higher probability of ischemic stroke.

show abstract

Section: Toyota Prehospital Stroke Scale For T-pa Intravenous Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%