Validation of admission criteria to a stroke unit

Recent and sudden onset of focal neurological deficit as criteria for admission to a stroke unit was evaluated prospectively in 2252 consecutive admissions to a medical department. According to the criteria, 169 patients were initially suspected of having an acute cerebrovascular disorder. This was later confirmed in all but 17 of them. Another 24 patients, not correctly classified initially, also turned out to have suffered a stroke. In practice, sensitivity of the criteria was, therefore, 86% and specificity 99%. Had the criteria been more strictly adhered to in the emergency ward, sensitivity could have increased to 97%, and specificity to 100%. Thus, simple criteria of this kind seem appropriate for a standardized identification of stroke in the acute situation.