Abstract Number: Esoc2026a1377 Real-World Agreement of Nihss Scores Between Paramedics and Stroke Physicians in Suspected Stroke: Secondary Analysis From the Paranaspp Trial
Secondary analysis evaluates NIHSS score agreement in suspected stroke cases, suggesting feasibility of prehospital assessment.
Key Points
This analysis aims to assess the agreement of NIHSS scores between paramedics and stroke physicians in real-world conditions.
Secondary analysis of patients from the ParaNASPP trial conducted in Oslo (2019–2021) with prehospital NIHSS scores.
Agreement assessed with Bland–Altman analysis and Cohen’s kappa for dichotomized NIHSS categories.
Sensitivity analyses evaluated agreement over different time intervals (≤30, 31–60, >60 minutes).
A total of 443 patients analyzed with a mean difference in NIHSS scores of 0.76 points (LoA: –5.90 to +7.42, Grade B).
Interrater reliability for dichotomized NIHSS categories was very good (κ = 0.87).
Weighted kappa scores for individual items ranged from 0.90 to 0.98, indicating strong agreement, particularly for consciousness, facial palsy, and motor function.