Comparison of Siriraj Stroke Score with Computed Tomography to Differentiate Acute Embolic and Hemorrhagic Stroke in a Tertiary Care-Teaching Center

Aim: The study aimed to compare Siriraj Stroke Score (SSS) with computed tomography (CT) in differentiating stroke subtypes.
Materials and Methods: This cross-sectional study consists of eighty consecutive patients admitted to the emergency department of the tertiary care-teaching center within four hours of the onset of stroke. A single experienced emergency medicine physician observed the patients for Siriraj score. An independent radiologist analyzed the CT of the patients who was not aware of the clinical condition. CT findings were considered the gold standard. Siriraj score findings were considered as a screening test. The sensitivity, specificity, predictive values, and diagnostic accuracy of the screening test, along with their 95% CI, were presented.
Results: A total of 80 subjects were included in the study. The mean age of the participants was 56.4 years, with the majority being males (58.8%). The sensitivity and specificity for SSS were 96.92% and 90.91%, respectively. The Siriraj stroke score had excellent predictive validity in predicting CT findings, as indicated by the area under the curve of 0.994 (95% CI 0.983 to 1.000, P value <0.001).
Conclusion: The clinical score, Siriraj stroke score, showed high sensitivity and specificity, and the results were satisfactory compared with CT imaging. Thus, it was concluded that Siriraj stroke score could be used for the bedside diagnosis to differentiate stroke subtypes in settings where CT scan facility is lacking.