According to the case report form (CRF) 210 out of 1537 patients underwent intravenous thrombolysis. Information about thrombolysis was missing for 2999 patients because this item was included later and not asked for all patients. The indication for AMN-107 thrombolysis was left to the participating centres, according to their local structured operating procedures. Frequencies of presenting symptoms were analysed in two modifications. At first the number of cases
exhibiting FAST symptoms, that is, face palsy or problems with arm/paresis or speech were simply calculated as percentage from the whole cohort. Additionally a Venn diagram was plotted for those with at least one FAST symptom to check frequencies of combinations of symptoms. Alternatively, the frequency of each symptom was calculated in a sequential approach. After sizing the most frequent symptom, the second frequent symptom was extracted from the remaining cases and so on. This approach allows establishing a ‘hierarchy’ of stroke signs with regard to those symptoms that most often occur aiming to identify as many as possible patients with stroke employing as few symptoms as possible to create a comprehensive public message. To test differences in subgroups according to age, sex or severity of stroke we used multilevel logistic models to account for the heterogeneity between centres. All analyses were calculated using commercially available software:
PASW Statistics 18, Release V.18.0.2 (copyright SPSS, Inc. 2009, Chicago, Illinois, USA) and SAS software, V.9.2 of the SAS System for Windows (copyright 2008 SAS Institute Inc. Cary, North
Carolina, USA). Results Frequency of presenting symptoms A total of 5024 patients were enrolled in the study between 2007 and 2010. A total of 4535 patients with TIA (n=1071), ischaemic stroke (n=3396) or other (n=68, refers to cerebral vein thrombosis or no documented entity) were included in the analysis. In general 76.5% of the young strokes included in sifap1 had clinical signs covered by FAST criteria. Table 2 specifies the frequency of FAST symptoms according to gender and age. Face was more frequently affected in men. FAST signs were more prevalent in older age groups; this difference becomes even more obvious in younger patients below 25 years where the capture rate of FAST signs is below 70%. Table 2 Frequency of presenting Cilengitide symptoms according to FAST stratified by gender and age Figure 1 shows the frequency of combinations of FAST symptoms; 34.7% of those with at least one FAST symptom have all three symptoms; 17.3% have only arm problems or paresis; 16.6% have only speech problems and 15.7% have both arm problems/paresis and speech problems. The isolated symptom ‘Face’ is very rare (2.5%). Figure 1 Venn diagram of FAST symptoms in those with at least one symptom (n=3469). Symptoms which were registered in the sifap1 cohort but were not considered for FAST are listed in table 3.