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Health services research
Research
Clinical signs in young patients with stroke related to FAST: results of the sifap1 study
  1. Manfred Kaps1,
  2. Ulrike Grittner2,
  3. Gerhard Jungehülsing3,
  4. Turgut Tatlisumak4,
  5. Christoph Kessler5,
  6. Reinhold Schmidt6,
  7. Putaala Jukka4,
  8. Bo Norrving7,
  9. Arndt Rolfs8,
  10. Christian Tanislav1
  11. on behalf of the sifap1 Investigators
  1. 1Department of Neurology, Justus Liebig University, Giessen, Germany
  2. 2Department of Biostatistics and Clinical Epidemiology, Charité- University Medicine Berlin, Berlin, Germany
  3. 3Department of Neurology, Charité, Berlin, Germany
  4. 4Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
  5. 5Department of Neurology, Moritz Arndt University Greifswald, Greifswald, Germany
  6. 6Department of Neurology, University of Graz, Graz, Austria
  7. 7Department of Neurology, Lund, Sweden
  8. 8Albrecht-Kossel Institute for Neuroregeneration, University of Rostock, Rostock, Germany
  1. Correspondence to Dr Christian Tanislav; Christian.Tanislav{at}neuro.med.uni-giessen.de

Abstract

Objectives The present study aimed to evaluate the frequency of warning signs in younger patients with stroke with a special regard to the ‘FAST’ scheme, a public stroke recognition instrument (face, arm, speech, timely).

Setting Primary stroke care in participating centres of a multinational European prospective cross-sectional study (Stroke in Young Fabry Patients; sifap1). Forty-seven centres from 15 European countries participate in sifap1.

Participants 5023 acute patients with stroke (aged 18–55 years) patients (96.5% Caucasians) were enrolled in the study between April 2007 and January 2010.

Primary and secondary outcome measures sifap1 was originally designed to investigate the relation of juvenile stroke and Fabry disease. A secondary aim of sifap1 was to investigate stroke patterns in this specific group of patients. The present investigation is a secondary analysis addressing stroke presenting symptoms with a special regard to signs included in the FAST scheme.

Results 4535 patients with transient ischaemic attack (TIA; n=1071), ischaemic stroke (n=3396) or other (n=68) were considered in the presented analysis. FAST symptoms could be traced in 76.5% of all cases. 35% of those with at least one FAST symptom had all three symptoms. At least one FAST symptom could be recognised in 69.1% of 18–24 years-old patients, in 74% of those aged 25–34 years, in 75.4% of those aged 35–44 years, and 77.8% in 45–55 years-old patients. With increasing stroke severity signs included in the FAST scheme were more prevalent (National Institute of Health Stroke Scale, NIHSS<5: 69%, NIHSS 6–15: 98.9%, NIHSS>15: 100%). Clustering clinical signs according to FAST lower percentages of strokes in the posterior circulation (65.2%) and in patients with TIA (62.3%) were identified.

Conclusions FAST may be applied as a useful and rapid tool to identify stroke symptoms in young individuals aged 18–55 years. Especially in patients eligible for thrombolysis FAST might address the majority of individuals.

Study registration The study was registered in http://www.clinicaltrials.gov (No. NCT00414583).

  • HEALTH SERVICES ADMINISTRATION & MANAGEMENT
  • EPIDEMIOLOGY
  • MEDICAL EDUCATION & TRAINING
  • NEUROLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-005276

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