Abstrak: Latar belakang: Upaya mengenal nyeri sentral pada pasien pascastroke dapat dilakukan dengan menyediakan alat bantu diagnosis. Penelitian ini bertujuan untuk mengembangkan sistem skoring diagnostik nyeri sentral pascastroke (NSPS) di rumah sakit, dan menganalisis akurasi dan reliabilitas penggunaan sistem skoring tersebut di puskesmas. Metode: Penelitian ini merupakan penelitian dengan rancangan potong-lintang dan merupakan studi diagnostik pada 166 pasien di rumah sakit dan 303 pasien di puskesmas se-wilayah Kota Manado dan sekitarnya. Hasil: Terdapat tiga variabel utama yang dominan sebagai determinan NSPS berdasarkan uji regresi cox yakni keparahan stroke, defisit nyeri tajam dan defisit raba halus. Prevalensi NPSP di rumah sakit berdasarkan baku emas didapatkan sebesar 30,1%. Dengan titik potong skor ≥2 maka didapatkan nilai sensitifitas 82,0% dan sensitifitas 78,45%. Berdasarkan perhitungan menurut teorema Bayes maka didapatkan probabilitas NSPS di RS dengan skor ≥2 sebesar 62,12%, dan <2 sebesar 8,98%. Berdasarkan hasil pemeriksaan spesialis neurologik di puskesmas maka didapatkan prevalensi NSPS di puskesmas berdasarkan skor Sasmita adalah sebesar 40,9%. Hasil uji akurasi menunjukkan sensitivitas skor Sasmita oleh spesialis neurologi dan dokter umum di puskesmas adalah 71,61% dan sensitivitas 76,35%. Perhitungan dengan teorema Bayes didapatkan probabilitas NSPS di puskesmas dengan skor skor ≥2 sebesar 67,69%, dan <2 sebesar 20,42%. Uji reliabilitas antar dokter umum di puskesmas adalah sebesar 0,576. Kesimpulan: Terdapat tiga variabel utama yang dominan sebagai determinan NSPS yakni keparahan stroke, defisit nyeri tajam dan defisit raba halus. Secara deskriptif didapatkan bahwa kualitas hidup pasien stroke dengan NSPS adalah lebih rendah dibandingkan tanpa NSPS. Pada keseluruhan pasien dengan NSPS, domain yang paling sering mengalami gangguan adalah energi. Saran: Skor Sasmita dapat digunakan sebagai dalam penelitan selanjutnya terkait epidemiologi klinik nyeri pascastroke.

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Introduction: The identification of central poststroke pain (CPSP) can be facilitated by the provision of diagnostic tools. This study aimed to develop a diagnostic scoring system for CPSP in hospital settings and to analyze the accuracy and reliability of its use in Puskesmas. Method: This cross-sectional diagnostic study was conducted on 166 hospital and 303 stroke survivors from Puskesmas in Manado City and its outskirts area. Result: Based on cox regression, three key variables were identified as dominant determinants of CPSP: stroke severity, pin-prick deficit, and light-touch deficit. The prevalence of CPSP in hospitals, determined using the gold standard, was 30.1%. With a cut-off score of ≥2, the sensitivity and specificity were 82.0% and 78.45%, respectively. Using Bayes' theorem, the probability of CPSP in hospitals with a score ≥2 was 62.12%, and <2 was 8.98%.  At the primary health centers, neurological specialist examinations revealed a CPSP prevalence of 40.9% based on the Sasmita scoring system. The accuracy test showed that the sensitivity of the Sasmita score assessed by neurologists and general practitioners was 71.61% and 76.35%, respectively. Bayes' theorem calculations indicated a CPSP probability at the Puskesmas of 67.69% with a score ≥2 and 20.42% with a score <2. Inter-rater reliability testing among general practitioners yielded a value of 0.576. Descriptively, stroke patients with CPSP had lower quality of life compared to those without CPSP, with the most commonly affected domain being energy. Conclusion: Three key variables were identified as dominant determinants of CPSP: stroke severity, pin-prick deficit, and light-touch deficit. The prevalence of CPSP in this study is relatively high both at hospital and Puskesmas settting. Sasmita score has good accuracy and moderately reliable in detecting CPSP at primary and tertiary care level. Suggestion: The Sasmita scoring system can be utilized in future studies related to the clinical epidemiology of poststroke pain. Serial assessment is encouraged to be conducted for high risk poststroke patients.