Comparing FAST and BEFAST in Acute Stroke Patients: A Systematic Review
Keywords:
Stroke, FAST, BFAST, infarct, ischaemicAbstract
Background: Stroke leads to cerebral infarct, and time increases risk of infarct progression to healthy tissue. Further insult and secondary neuronal injury (such as hypoxia) can accelerate the progression of the infarct. The only definitive management strategies for ischaemic stroke are reperfusion and endovascular thrombectomy. Methods: This systematic review focused on full-text English literature published between 2014 and 2024 using the PRISMA 2020 guidelines. Editorials and review pieces published in the same journal as the submission without a DOI were not accepted. The literature was compiled using Medline, Science Direct, Scopus and Embase, among other online venues. Result: Five publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: FAST is a useful screening tool for identifying stroke at call-taker level. FAST has acceptable sensitivity when used as a screening tool; however, specificity and diagnostic effectiveness are lacking.
References
Chen X, Zhao X, Xu F, Guo M, Yang Y, Zhong L, et al. A Systematic Review and Meta-Analysis Comparing FAST and BEFAST in Acute Stroke Patients. Front Neurol. 2022;12(January).
Crause K, Stassen W. The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre. South African J Crit Care. 2020;36(1):35–8.
Devlin S. Not so FAST: pre-hospital posterior circulation stroke. Br Paramed J. 2022;7(1):24–8.
Singhal V, Prabhakar H. Readiness of the Stroke Treatment in India – Still an Uphill Task! Indian J Crit Care Med. 2023;27(9):607–8.
Hogge C, Goldstein LB, Aroor SR. Mnemonic utilization in stroke education: FAST and BEFAST adoption by certified comprehensive stroke centers. Front Neurol . 2024;15(March):1–3.
Jones SP, Bray JE, Gibson JME, McClelland G, Miller C, Price CI, et al. Characteristics of patients who had a stroke not initially identified during emergency prehospital assessment: A systematic review. Emerg Med J. 2021;38(5):387–93.
Herpich F, Rincon F. Management of Acute Ischemic Stroke. Crit Care Med. 2020;48(11):1654–63.
Saceleanu VM, Toader C, Ples H, Covache-Busuioc RA, Costin HP, Bratu BG, et al. Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations. Biomedicines. 2023;11(10):1–59.
Chugh C. Acute ischemic stroke: Management approach. Indian J Crit Care Med. 2019;23:S140–6.
El Ammar F, Ardelt A, Del Brutto VJ, Loggini A, Bulwa Z, Martinez RC, et al. BE-FAST: A Sensitive Screening Tool to Identify In-Hospital Acute Ischemic Stroke. J Stroke Cerebrovasc Dis [Internet]. 2020;29(7):104821. Available from: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104821
Ekkert A, Milmantienė D, Jokimaitytė U, Jatužis D. Posterior Circulation Stroke Patients Receive Less Reperfusion Therapy Because of Late Arrival and Relative Contraindications: A Retrospective Study. J Clin Med. 2023;12(16).
Pickham D, Valdez A, Demeestere J, Lemmens R, Diaz L, Hopper S, et al. Prognostic Value of BEFAST vs. FAST to Identify Stroke in a Prehospital Setting. Prehospital Emerg Care [Internet]. 2019;23(2):195–200. Available from: https://doi.org/10.1080/10903127.2018.1490837
Aroor S, Singh R, Goldstein LB. BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic. Stroke. 2017;48(2):479–81.
Dharmasaroja P, Uransilp N. Stroke Awareness and Knowledge in the At-Risk Population: A Community-Based Study. Cureus. 2024;16(4):4–12.
Meyran D, Cassan P, Avau B, Singletary E, Zideman DA. Stroke Recognition for First Aid Providers: A Systematic Review and Meta-Analysis. Cureus. 2020;12(11).
Tapuwa D, Musuka M, Wilton S, Traboulsi M. Diagnosis and Management of Acute Ischemic Stroke: Speed is Critical. Cmaj [Internet]. 2015;187(12):887–93. Available from: https://pubmed.ncbi.nlm.nih.gov/26243819/
Glober NK, Sporer KA, Guluma KZ, Serra JP, Barger JA, Brown JF, et al. Acute Stroke: Current Evidence-based recommendations for prehospital care. West J Emerg Med. 2016;17(2):104–28.
Eddelien HS, Butt JH, Christensen T, Danielsen AK, Kruuse C. Sex and Age Differences in Patient-Reported Acute Stroke Symptoms. Front Neurol. 2022;13(March):1–9.
Jing Z, Renyu L. Calling for a rapid recognition and response program for stroke in China. Breast Cancer Res [Internet]. 2017;18(1):100–106. Available from: http://dx.doi.org/10.1186/s13023-016-0543-7%0Ahttp://dx.doi.org/10.1080/15384101.2017.1312236%0Ahttp://breast-cancer-research.com/content/13/4/R73%0Ahttp://dx.doi.org/10.1186/s13046-016-0410-3%0Ahttp://dx.doi.org/10.1016/j.ajpath.2017.07.011%0Ahttps://doi.org/10.10
Wanichanon W, Ananchaisarp T, Buathong N, Choomalee K. Knowledge and attitude towards stroke among the population of one rural community in southern Thailand: a survey. BMJ Open. 2024;14(2):1–10.
Chiu LQ, Quek DYJ, Salihan RB, Ng WM, Othman RB, Lee CH, et al. ACT-FAST: A quality improvement project to increase the percentage of acute stroke patients receiving intravenous thrombolysis within 60 minutes of arrival at the emergency department. Singapore Med J. 2021;62(9):476–81.
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