Quality Project: Implementation of an adapted prehospital stroke score (APPS Plus) as a contribution to more efficient acute stroke management in Lower Austria.

Background: Strokes of the posterior circulation are often recognized too late and therefore receive less frequently a timely and effective therapy. Stroke scores commonly used so far for a reliably prehospital diagnosis insufficiently cover disorders of the posterior cerebral circulation.

Research Question: Does the introduction of an adapted and extended prehospital stroke score lead to better diagnosis and management of strokes in the posterior circulation?

Method: The APSS (Austrian Prehospital Stroke Scale) already used in the emergency services in Lower Austria will be extended with two assessment points that query symptoms of the posterior circulation (i.e. balance disorder and double vision)  with the intention to improve the accuracy of the prehospital diagnosis. This should enable more quickly and frequently an adequate acute treatment for ischemic strokes of the posterior circulation

The diagnostic and therapeutic benefit of the extended score APSS+ will be assessed by a time series comparison (before and after the introduction of APSS+). 720 patient data sets will be analysed in this research part of an overarching quality improvement project that  aims to collect data from 3000 patients in total.