Background: The burden of stroke in India is already high and likely to increase, but few patients with stroke particularly in rural setting have access to brain imaging. Distinguishing pathologic stroke types is relevant both for clinical management and epidemiologic studies. So in resource limited settings scoring system based on discriminant analysis technique and multivariate logistic regression have been developed to distinguish cerebral haemorrhage from cerebral infarction. Aims & Objectives: In this study we aimed to establish the accuracy of Siriraj Stroke Score in the bedside diagnosis of types of stroke in comparison with a neuroimaging technique usually CT scan. Methods: This is a cross-sectional observational study conducted for seven months from April to November 2017. Patients who met the inclusion criteria were inquired about variables of Siriraj Stroke Score and scored accordingly. Results were compared with the findings of CT scan. Sensitivity and specificity of the score for haemorrhagic and ischemic stroke was tested against computed CT of brain as a gold standard. Sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for diagnostic accuracy in distinguishing stroke subtypes taking CT scan as gold standard. Results: Total 1000 patients were included in the study. Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value of Siriraj Stroke Score for haemorrhagic stroke was 85%, 82%, 92% and 68% respectively. Overall accuracy for haemorrhagic stroke was found to be 84%. In cases of ischemic stroke the Sensitivity, Specificity and Positive predictive Value was 82%, 92% and 67% respectively. There was no significant statistical correlation between the variables and stroke subtypes. Conclusion: Siriraj Stroke Score had higher sensitivity for haemorrhagic stroke and is more sensitive in Asian population, but still not accurate enough to replace CT scan as investigation of choice particularly where definitive therapy like anticoagulation or thrombolysis is considered but can plays a role to avoid delay in the management where CT scan is delayed or not available.
