SALVO- Speedy Detection of Large Vessel Occlusion - Ischemic Stroke in Hyper Acute Setting (P1.3-045)

Objective: The objective is to validate a new simplistic stroke scale, Sinai Assessment for Large Vessel Occlusion (SALVO). Background: Several stroke severity scales have been developed but are often complex or have low sensitivity and/or specificity. Early detection of large vessel occlusions can decrease time to intervention. Design/Methods: Based on literature review we developed a 4-item stroke scale evaluating: 1) level of consciousness; 2) gaze palsy/deviation; 3) speech; and 4) motor functions. Each item is graded from 0 to 2: 0 indicative of normal findings, 1 mild findings and 2 severe findings. A retrospective study was performed in two hospitals, Mount Sinai - 319 bed hospital and Holy Cross - 264 bed hospital between 10/01/2016 – 01/18/2018. Initial cohort of 1059 patients included all patients whom a “Code Stroke” was initiated. Due to cancelled codes, hemorrhagic strokes, or lack of information in electronic medical records, 543 patients were excluded from the analysis. Demographic and stroke-related data (e.g. NIH stroke scale (NIHSS), MRI/CTA findings, thrombolysis etc) were collected and analyzed. A SALVO score was retrospectively assigned based on clinical documentation. For statistical analysis, Stata SE 10.0 and Minitab 18 were used. Results: Among 518 patients included analyzed, 92 (17.8%) had a confirmed LVO whereas 426 (82.2%) did not. Only 368 patients (71%) had the NIHSS available in their charts. A statistically significant correlation was observed between SALVO and NIHSS (p Conclusions: The SALVO score has promising accuracy in prediction of LVO in hyper-acute setting. A prospective study would be beneficial to compare it to other stroke severity scale and determine inter-rater reliability between emergency medical service personnel, emergency department nurses, and emergency medicine physicians. Disclosure: Dr. Philip has nothing to disclose. Dr. Beckstrom has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with MetroSouth Medical Center. Dr. Rai has nothing to disclose. Dr. Kunkala has nothing to disclose. Dr. Mendoza has nothing to disclose. Dr. Verda has nothing to disclose. Dr. Bhupali has nothing to disclose.