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42 BACKGROUND: The Los Angeles Prehospital Stroke  Screen (LAPSS) has been shown in a prospective, in the field validation  study to identify stroke patients with high sensitivity and  specificity. For prehospital clinical trials, it is desirable to  develop an instrument that rapidly characterizes stroke severity  (clinimetric measure) in addition to stroke recognition tools  (diagnostic measure). Shortened versions of the NIHSS have been  proposed for this purpose. However, a motor score derived from the  LAPSS 3 item motor exam may serve this purpose more efficiently.METHODS: The LAPSS Motor Scale (LAMS) was constructed by  assigning point values to LAPSS items of facial weakness (0,1), arm  strength (0,1,2) and grip (0,1,2) to yield a total 0–5 scale. 87  patients enrolled in UCLA Stroke Network acute stroke clinical trials  were analyzed. The presenting LAMS score was derived based on the  recorded presenting NIHSS and grip exam. Correlations were calculated  between the LAMS and 3 month functional outcomes, including NIHSS,  modified Rankin, GOS, and Barthel Index. Predictive performance of the  LAMS was compared with that of the initial full NIHSS and the 5 item  shortened NIHSS (sNIHSS).Results: The average LAMS score  was mean 2.6, median 2. LAMS score correlations with the 3 month  functional outcome measures were highly statistically significant, and  comparable to that of the longer sNIHSS and full NIHSS: 3 mo GOS - LAMS  0.55, sNIHSS 0.51, NIHSS 0.64; 3 mo BI - LAMS 0.49, sNIHSS 0.47, NIHSS  0.57; 3 mo mRS - LAMS 0.45, sNIHSS 0.54, NIHSS 0.54; 3 mo NIHSS - LAMS  0.50, sNIHSS 0.51, NIHSS 0.57. Considering dichotomized 3 mo measures,  LAMS scores were markedly lower in patients destined for excellent  outcome: 3 mo GOS=1, 3.4 vs 1, p&lt;.0001 ; 3 mo mRS≤1, 3.8 vs 2.6,  p=.06; 3 mo BI≥95, 3.6 vs 1.9, p&lt;.0001; 3 mo NIHSS≤1, 2.2 vs 3.7,  p&lt;.001.Conclusions: A motor score easily and quickly  derived from the Los Angeles Prehospital Stroke Screen quantitatively  characterizes stroke severity in the field, and predicts functional  outcomes with accuracy nearly comparable to that of the full NIHSS.  Field use of the LAPSS would allow rapid identification of stroke  patients and usefully delineate stroke severity.

The LAPSS Motor Scale (LAMS): A New Measure for Characterizing Stroke Severity in the Field