Objectives The present study aimed to evaluate the frequency of warning signs
in younger patients with stroke with a special regard to the ‘FAST’ scheme, a
public stroke recognition instrument (face, arm, speech, timely). Setting
Primary stroke care in participating centres of a multinational European
prospective cross-sectional study (Stroke in Young Fabry Patients; sifap1).
Forty-seven centres from 15 European countries participate in sifap1.
Participants 5023 acute patients with stroke (aged 18–55 years) patients
(96.5% Caucasians) were enrolled in the study between April 2007 and January
2010. Primary and secondary outcome measures sifap1 was originally designed to
investigate the relation of juvenile stroke and Fabry disease. A secondary aim
of sifap1 was to investigate stroke patterns in this specific group of
patients. The present investigation is a secondary analysis addressing stroke
presenting symptoms with a special regard to signs included in the FAST
scheme. Results 4535 patients with transient ischaemic attack (TIA; n=1071),
ischaemic stroke (n=3396) or other (n=68) were considered in the presented
analysis. FAST symptoms could be traced in 76.5% of all cases. 35% of those
with at least one FAST symptom had all three symptoms. At least one FAST
symptom could be recognised in 69.1% of 18–24 years-old patients, in 74% of
those aged 25–34 years, in 75.4% of those aged 35–44 years, and 77.8% in 45–55
years-old patients. With increasing stroke severity signs included in the FAST
scheme were more prevalent (National Institute of Health Stroke Scale,
NIHSS15: 100%). Clustering clinical signs
according to FAST lower percentages of strokes in the posterior circulation
(65.2%) and in patients with TIA (62.3%) were identified. Conclusions FAST may
be applied as a useful and rapid tool to identify stroke symptoms in young
individuals aged 18–55 years. Especially in patients eligible for thrombolysis
FAST might address the majority of individuals
