The E-ASPECTS Improves The Performance Of Emergencists In The Evaluation Of Early Signs Of Ischemia (5174)

Objective: Asses the performance of the emergencists in the evaluation of ASPECTS score with and without e-ASPECTS. Background: The evaluation of early signs of ischemia in non-contrast brain CT (NCCT) is a challenge for professionals unfamiliar with their routine interpretation, such as emergencits. The correct identification of areas where there is injury and that there is no injury, allows the quick and accurate treatment of acute ischemic stroke. In order to assist these professionals, the e-ASPECTS, a full automated, reliable, validated and fast tool, determines by ASPECTS score which patients may be eligible for thrombolysis or thrombectomy. Design/Methods: We selected 116 patients admitted in the stroke unit of Hospital de Clinicas of the Federal University of Parana between March 2017 and February 2018 with symptoms of anterior circulation stroke. Patients with symptoms improvement, without control NCCT or MRI or other final diagnoses were excluded. Two blinded emergencists and two neuroradiologists for any clinical data evaluated the admission NCCT without e-ASPECTS. After 30 days, they re-evaluated the imagens in a new randomized order, but now, they were able to use the e-ASPECTS. The ASPECTS values attributed by the evaluators were dichotomized in scores equal to 10, for images injury free, or different to 10, for those with any ischemic lesion, Sensitivity, specificity, Matthews correlation coefficients (MCC) and ROC curves were generated for analysis before e after the software use. Results: The emergencits improves their performance when they could use the e-ASPECTS, getting closer to the results obtained by neuroradiologists. In the initial evaluation, MCC values for emergencits were −0.01 and 0.04, and, after the program assistance, were 0.38 and 0.43, respectively, approaching the neuroradiologists (0.53 for NR1 and 0.39 for NR2). Conclusions: The e-ASPECTS assist and improves performance of the stroke care front line professionals in the evaluation early signs of ischemia in NCCT. Disclosure: Dr. Ferreti has nothing to disclose. Dr. Leitao has nothing to disclose. Dr. Teixeira has nothing to disclose. Dr. Zetola has nothing to disclose. Dr. Lange has nothing to disclose.