The Cardiovascular
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RACE Scale for Stroke (Large-Vessel Occlusion)

Prehospital scale to identify large-vessel occlusion in acute stroke.

RACE Scale for Stroke (Large-Vessel Occlusion)
Facial palsy
Arm motor function
Leg motor function
Head and gaze deviation
Aphasia (if right hemiparesis) or agnosia (if left hemiparesis)
Result0 points

Score <5: large-vessel occlusion less likely.

LVO threshold
>= 5 points

When to use

  • Prehospital or ED screening for anterior large-vessel occlusion warranting thrombectomy triage.

Formula

Sum of five items: facial palsy (0-2), arm motor (0-2), leg motor (0-2), gaze deviation (0-1), aphasia or agnosia (0-2). Range 0-9; >=5 suggests large-vessel occlusion.

Pearls and pitfalls

  • Derived from and correlates with the NIHSS but is faster to apply in the field.
  • Assess aphasia when hemiparesis is right-sided and agnosia when it is left-sided.

References

  1. Perez de la Ossa N, et al. Stroke. 2014;45(1):87-91.