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The RACE (Rapid Arterial oCclusion Evaluation) scale is a prehospital tool that scores 5 items — facial palsy, arm motor, leg motor, gaze deviation, and aphasia/agnosia — on a 0–9 scale. A score of 5 or more suggests a large vessel occlusion stroke.
RACE = Facial palsy (0–2) + Arm motor (0–2) + Leg motor (0–2) + Gaze deviation (0–1) + Aphasia or agnosia (0–2) → total 0–9
0–9; score ≥ 5 suggests large vessel occlusion (sensitivity 0.85, specificity 0.68) and supports transport to an endovascular-capable center.
The RACE scale was developed and validated by Pérez de la Ossa and colleagues (Stroke 2014) specifically for prehospital identification of large vessel occlusion (LVO) in acute ischemic stroke. It scores facial palsy, arm and leg motor function, gaze deviation, and the presence of aphasia or neglect/agnosia, giving a total of 0–9. A cut-off of 5 yielded a sensitivity of 0.85 and specificity of 0.68 for LVO, enabling earlier activation of endovascular stroke pathways.
Specialty
NeurologyCategory
NeurologyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-16
Formula
Keywords
Normal Range
0–9; score ≥ 5 suggests large vessel occlusion (sensitivity 0.85, specificity 0.68) and supports transport to an endovascular-capable center.
| Classification | Range |
|---|---|
LVO unlikely Lower probability of large vessel occlusion | 0–4 |
LVO suspected Suggestive of large vessel occlusion — activate endovascular pathway | 5–9 |
A prehospital stroke scale that scores facial palsy, arm and leg motor function, gaze deviation, and aphasia/agnosia to identify large vessel occlusion (LVO) in acute ischemic stroke, with a total of 0–9; a score ≥ 5 suggests LVO.
Scores of 0–4 indicate a lower probability of large vessel occlusion; scores ≥ 5 suggest LVO (sensitivity 0.85, specificity 0.68) and warrant activation of the endovascular stroke pathway.
The RACE scale enables prehospital identification of large vessel occlusion, allowing direct transport to thrombectomy-capable centers and reducing delays to endovascular treatment.
An EMS crew evaluates an elderly patient with dense left facial palsy (2), left arm plegia (2), left leg plegia (2), conjugate gaze deviation to the right (1), and inability to name objects or identify her own arm (2).
Inputs:
RACE 9/9 — large vessel occlusion suspected; transport to an endovascular-capable stroke center.
It predicts large vessel occlusion, making the patient a candidate for direct transport to a center offering mechanical thrombectomy.
No. RACE is a focused prehospital triage tool; the NIHSS provides a more complete severity assessment in the hospital.
In-hospital assessment and monitoring
Post-TIA early stroke risk
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. The RACE scale supports, but does not replace, clinical judgment and regional stroke transport protocols.