A retrospective external validation study of the TriAGe+ score among stroke patients presenting to the emergency department with vertigo

Augustin Bahu, Céline Occelli, Jacques Levraut, Jean-Paul Fournier, Julie Contenti, Clair Vandersteen


OBJECTIVE : Acute vertigo account for 4% of the reasons for consultations in the Emerency Department (ED) and are mainly of peripheral etiology. The challenge of caring for these patients is to rule out a central etiology, which can be life-threatening. Given the frequency and severity of strokes and the difficulties detecting them in the context of acute vertigo, it is useful to have a clinical score for reliable, early screening to guide clinicians in their imaging examination requests. The main objective of our study was to assess and validate the TriAGe+ score as a stroke screening tool in the context of acute vertigo or dizziness.     

MATERIALS AND METHODS : We conducted a single-center retrospective observational study including patients admitted to the emergency department of the University Hospital between January 2015 and December 2019 for acute dizziness and/or vertigo who had a brain MRI within 72 hours of admission.

RESULTS : We included 444 patients, 73 of whom had a stroke. The mean TriAGe+ score was 7.6±2.8 in our cohort. The AUC ROC for stroke prediction of this score is 0.717 and a cutoff value of ≥5 seems relevant to guide imaging to avoid overlooking stroke (PPV=19%; CI=15-23 and NPV = 100%, CI=94-100).

CONCLUSION : The TriAGe+ score appears to be effective in its ability to predict the presence of stroke, particularly in the posterior fossa, in the setting of vertigo symptomatology in the emergency department.

Palabras Clave

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