The Rapid Arterial Occlusion Evaluation (RACE) scale can be used to identify a patient with a large arterial occlusion during prehospital assessment. This can help to triage the patient upon arrival at the tretment center. The authors are from Hospital Universitari Germans Trias I Pujol, Universitat Autonoma de Barcelona, Sistema d'Emergencies Mediques de Catalunya and Grup Ambulancies La Pau in Barcelona, Spain.
Patient selection: acute stroke
Parameters:
(1) facial palsy
(2) arm motor function
(3) leg motor function
(4) head and gaze deviation
(5) aphasia (if right hemiparesis) or agnosia (if left hemiparesis)
Parameter
Finding
Points
facial palsy
none
0
mild
1
moderate to severe
2
arm motor function
normal to mild
0
moderate
1
severe
2
leg motor function
normal to mild
0
moderate
1
severe
2
head and gaze deviation
absent
0
present
1
aphasia (right hemiparesis)
2 tasks done correctly
0
1 task done correctly
1
0 tasks done correctly
2
agnosia (left hemiparesis)
2 items recognized
0
1 item recognized
1
0 items recognized
2
where:
• For aphasia the patient is asked (1) to close the eyes and (2) to make a fist
• For agnosia the tasks are to recognize the left arm and to recognize the impairment.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• A score >= 5 indicates a large arterial occlusion.
Performance:
• A score >= 5 has a sensitivity of 85% and specificity of 68%
• The reported area under the ROC curve was 0.82.
To read more or access our algorithms and calculators, please log in or register.
