Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (12): 1699-1705.doi: 10.3969/j.issn.1674-8115.2022.12.007

• Clinical research • Previous Articles    

Exploring the score for rapid identification of cerebral infarction in patients with acute dizziness

LIN Guiming1(), LIU Fangfang1, YAN Mengxia1, BAO Guanshui1,2()   

  1. 1.Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
    2.Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2022-03-24 Accepted:2022-09-05 Online:2022-12-28 Published:2022-12-28
  • Contact: BAO Guanshui;
  • Supported by:
    Shanghai Wu Mengchao Medical Science Foundation(JJHXM-2019009)


Objective ·To predict the likelihood of cerebral infarction (CI) in emergency department patients with acute vestibular syndrome (AVS), and to evaluate the clinical value of modified TriAGe+ score. Method ·Patients with AVS admitted to the Emergency Department of Neurology of Shanghai Ninth People's Hospital from January 1, 2021 to August 31, 2021 were collected. There were 128 cases of CI and 127 cases of peripheral vertigo. t test or Mann-Whitney U test was used for inter-group comparison of quantitative data, and χ2 test was used for inter-group comparison of qualitative data. Receiver operating characteristic curve (ROC curve) and area under the curve (AUC) were used to compare the prediction effect of TriAGe+ score, age, blood pressure, clinical features, duration of symptoms and diabetes score (ABCD2 score) and posterior circulation ischemia (PCI) score for CI in patients with AVS. Logistic regression was used to study the influence of laboratory indicators on prediction of CI. The TriAGe+ score was then combined with laboratory indicators to formulate improved TriAGe+ score. Results ·In the two groups of variables, the proportion of male, hypertension, history of atrial fibrillation, no history of dizziness or vestibular labyrinth, and dizziness symptom in CI group was higher than that in peripheral vertigo group, and the difference was statistically significant (all P<0.05). Compared with ABCD2 score and PCI score, TriAGe+ score had the highest AUC (0.859, 95%CI 0.814?0.904), which was statistically significant (P=0.000). Multivariate Logistic regression results showed that blood glucose level (P=0.007) and blood uric acid level (P=0.008) were independent risk factors for predicting CI. When blood glucose level was greater than 7.95 mmol/L, the best AUC showed a sensitivity of 61.7% and specificity of 66.1%. At the same time, serum uric acid value greater than 382.5 μmol/L showed the best AUC with sensitivity of 35.2% and specificity of 85.0%. When the blood uric acid value is greater than 382.5 μmol/L, it is one point, and when the blood glucose value is greater than 7.95 mmol/L, it is one point, which is added to the TriAGe+ score to form the modified TriAGe+ score. The diagnostic value of the modified TriAGe+ score (AUC=0.872, 95%CI 0.828?0.915) was larger than TriAGe+ score (P=0.007). When the critical value of modified TriAGe+ score was 10.5, the diagnostic accuracy was the best, when the sensitivity was 81.3%, and the specificity was 80.3%. Conclusion ·The modified TriAGe+ score has better clinical application in identifying the occurrence of stroke in patients with acute vestibular syndrome.

Key words: cerebral infarction, stroke, vertigo, dizziness

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