Background: Patient with acute cerebral large artery occlusion (LAO) is the candidate for thrombectomy. LAO patient is difficult early detected by emergent triage according clinical symptoms. We aimed to investigate the usefulness of Glasgow coma scale (GCS) evaluation in acute stroke patients to predict possible LAO. 
Method: We retrospective evaluation our stroke registry data from 2015 to 2016. The patients diagnosed acute stroke in our emergency room within 6 hours of stroke onset were included. LAO was documented by MRI or CTA after admission. We analyzed the relationship between GCS and LAO. 
Results: Totally 681 acute stroke patients presenting our ER within 6 hours of stroke onset was included and calculated. 175 (25.7%) patients were LAO and possible candidate for thrombectomy therapy. In table 1, It showed LAO groups is significantly older age (73+/-12, P<0.05), more atrial fibrillation (45% vs 13%, p<0.001) and dense artery sign in non-contrast CT (61% vs 1.2%, P<0.001). Non-LAO group have more male gender (48% vs. 64%, P=0.01). In table 2, we showed GCS have good sensitivity (94%) and specificity (91%) to predict LAO stroke. The positive predict value (PPV) is 78% and negative predict value (NPV) is 98%.
Conclusion: GCS evaluation at triage can help to early detect LAO stroke patient and probably speed the protocol of intra-arterial thrombectomy.

Using Glasgow Coma Scale to Identify Large Artery Occlusion Stroke Patient