Assessment of utility of Siriraj Stroke Score (SSS) in stroke patients of Pt. BD Sharma PGIMS hospital, Rohtak, India

H. Singh, J. B. Gupta, M. S. Gupta, Rohit Aggarwal
2001 Medical Journal of Indonesia  
Abstrak India mempunyai populasi rural yang mayoritas miskin, di mana pemeriksaan CT-scan otak yang paling sering dianjurkan pada pasien stroke tidak selalu tersedia, sehingga para dokter India dalam membangun diagnosis seringkali harus mengandalkan hasiL evaluasi gejala klinik yang dapat dilakukon dengan menggunakan SSS (Siriraj Stroke Score). Obyektif penelitian: untuk menilai kegunaan SSS pada pasien stroke. Metodologi: sejumlah 60 pasien stroke dievaluasi menggunakan SSS dan perkiraan
more » ... dan perkiraan diagnosis dibuat dan kemudian dibandingkan dengan diagnosis pasti hasil pemeriksaan CT-scan otak. Penemuan utamd: dengan menggunakan SSS, diagnosis perkiraan ialah: infark otak(SSS < -1) pada32 subyek, perdarahanotak(SSS> + l) pada24 subyek, sedangkan4 subyek tak dapat ditentukan diagnosisnya (SSS di antara -l dan +l). Limapuluh subyek dengan diagnosis perkiraan dipasangkan dengan hasil diagnosis pasti menggunakan CT-scan. Hasilnya menunjukkan bahwa SSS mempunyai sensitifitas 93,7Vo, spesifisitas 76,6%, nilai prediksi positif 8I ,2Vo, nilai prediksi negatif 92Vo dengan akurasi keseluruhan sebesar 93,77o untuk diagnosis infark otak. [Jntukpasien dengan perdarahan otak, sensitifitas 83,37o, spesifisitas 92,5Vo, nilai prediksi positif86,8Vo, nilai prediksi negatif92,5Vo dengan akurasi keseluruhan 83,3Vo. Kesimpulan utama: bagi para dokter di daerah rural, SSS tampaknya cukup berguna dalam penatalaksanaan stroke, terutama bila pemeriksaan radiologi yang lebih canggih untuk penetapan diagnosis tidak tersedia oleh karena harga tak terjangkau atau apabila transportasi ke tempat pemeriksaan CT-scan terdekat berisiko tinggi bagi pasien. (Med J Indones 2001; l0: 164-8) Abstract India has predominantly poor rural population where braii CT scan, most often advised investigation in patients of stroke, may not always be available, hence Indian physician in such setting base his diagnosis on bed side sign evaluation for which Siriraj Stroke Score (SSS) could be helpful. Objective of stuily: to assess the utility a/SSS ln patienti of stroke. Methodology: sixty subjects of stroke were evaluated on SSS and 'probable' diagnosis so made was compared with CT scan's (brain) 'certain' diagnosis. Main finilings: b1t r.rslng SSS, the probable bedside diagnosis was cerebral infarct (score < -) ) in 32 subjects and cerebral haemorrhage (score > + 1 ) in 24 subjects while 4 subjects had indeterminant score (-1 to +l). Fifty subjects had their probable diagnosis matched with brain CT scan certain diagnosis. The above findings showed that SSS had 93.7Vo sensitivity, 76.6Vo specificity, 8J.2Vo positive predictive value, 92Va negative predictive value with an overall accuracy as 93.7Vo for diagnosis of cerebral infarction. For patients of cerebral haemorrhage the sensitivity was 83.3Vo, specificity was 92.5Vo, positive predictive value was 86.9Vo, negative predicitive values was 92.5Vo with overall accuracy as 83.3Vo. Prtncipal conclusion: physicians in the rural settings may find SSS to àe quite useful in the management of stroke especially where more sophisticated radiological investigations may not be available for confirmation of diagnosis due to high cost or attended due to transportation risk. (Med J Indones 2007; 10: 164-8)
doi:10.13181/mji.v10i3.26 fatcat:wduxdbo7cvcojokskoifkkngae