The effectiveness of the algorithm Stroke Gadjah Mada’s (ASGM) and Guy's Hospital Stroke Score (GHSS) in determining the type of etroke emergency in the emergency room of Dr. H. Moch Ansari Saleh hospital

Abstract

Introduction: Good stroke management depends on the speed and accuracy of the assessment system in diagnosing the type of stroke, in order to reduce mortality and morbidity. CT scan is a tool to differentiate the type of stroke, determine the location of the lesion and determine the severity of the disease. However, this tool is expensive and not all areas have it and the procedure takes quite a long time. Nurses need a diagnostic tool in the form of a simple assessment system including the Gadjah Mada Stroke Algorithm (ASGM) and Guy's Hospital Stroke Score (GHSS) which are easy, valid, reliable assessment tools in determining the type of stroke and preventing delays. Objectives:  Analyzing the comparison of the ASGM and GHSS scoring systems in determining the type of stroke emergency in the Emergency room. Methods:  This research method is quantitative pre-experimental design (posttest only design). The population was all stroke patients in the emergency room with 30 samples and the collection technique was accidental sampling. As for the stages, each respondent undergoes an ASGM assessment which consists of 3 components and GHSS 9 components. The statistical test used is the Paired Sample T-test, then an accuracy test is carried out by looking at the level of sensitivity and specificity. Results:  Based on the results of the Paired Sample T-test, the Sig value. amounting to 0.000 <0.05, which means there is a significant difference between the ASGM and GHSS scoring systems in determining the type of emergency in stroke patients. The average difference in the duration of determining the type of emergency and nursing diagnosis in the assessment system and ASGM and GHSS is 7.6 minutes. Furthermore, it also shows lower data of 7,066 and upper data of 8,134. This shows that the duration range for determining the type of emergency using ASGM is around 7.1 – 8.1 minutes faster compared to GHSS. Based on the accuracy test, the ASGM sensitivity level is 86.66% and the specificity level is 96.66%, while the GHSS sensitivity level is 56.66% and the specificity level is 63.33%.This difference is thought to be due to ASGM having more specific assessment variables for the brain, so that detecting suspected types of stroke in the acute phase is more accurate compared to GHSS. Conclusions: The ASGM and GHSS assessment methods are effective in determining the type of emergency in stroke patients in the ERHowever, in terms of duration, determining the type of emergency and.