Predictors of acute stroke mimics in 8187 patients referred to a stroke service.

MedStar author(s):
Citation: Journal of Stroke & Cerebrovascular Diseases. 22(8):e397-403, 2013 Nov.PMID: 23680681Institution: MedStar Washington Hospital CenterDepartment: NeurologyForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, N.I.H., IntramuralSubject headings: *National Institutes of Health (U.S.) | *Referral and Consultation | *Stroke/di [Diagnosis] | African Americans | Age Factors | Aged | Chi-Square Distribution | Comorbidity | Diagnosis, Differential | Emergency Medical Services | European Continental Ancestry Group | Female | Humans | Logistic Models | Male | Odds Ratio | Patient Care Team | Predictive Value of Tests | Prognosis | Prospective Studies | Risk Factors | Sex Factors | Stroke/eh [Ethnology] | Time Factors | United States/ep [Epidemiology]Year: 2013ISSN:
  • 1052-3057
Name of journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke AssociationAbstract: BACKGROUND: Some patients seen by a stroke team do not have cerebrovascular disease but a condition that mimics stroke. The purpose of this study was to determine the rate and predictors of stroke mimics in a large sample.CONCLUSIONS: One third of the patients seen by a stroke team over 10 years had a stroke mimic. Factors associated with a stroke mimic may be ascertained by an emergency physician before calling the stroke team.Copyright � 2013 National Stroke Association. All rights reserved.METHODS: This is an analysis of data from consecutive patients seen by the National Institutes of Health Stroke Program over 10 years. Data were collected prospectively as a quality improvement initiative. Patients with a cerebrovascular event or a stroke mimic were compared with the Student t or Pearson chi-square test as appropriate, and logistic regression was done to identify independent predictors.RESULTS: The analysis included 8187 patients: 30% had a stroke mimic. Patients with a stroke mimic were younger, and the proportion of patients with a stroke mimic was higher among women, patients without any risk factors, those seen as a code stroke or who arrived to the emergency department via personal vehicle, and those who had the onset of symptoms while inpatients. The proportion of patients with a stroke mimic was marginally higher among African-Americans than Caucasians. Factors associated with the greatest odds of having a stroke mimic in the logistic regression were lack of a history of hypertension, atrial fibrillation or hyperlipidemia.All authors: Benson RT, Davis LA, Hsia AW, Latour LL, Luby M, Lynch JK, Merino JG, Warach SFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2016-01-13
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 23680681 Available 23680681

BACKGROUND: Some patients seen by a stroke team do not have cerebrovascular disease but a condition that mimics stroke. The purpose of this study was to determine the rate and predictors of stroke mimics in a large sample.

CONCLUSIONS: One third of the patients seen by a stroke team over 10 years had a stroke mimic. Factors associated with a stroke mimic may be ascertained by an emergency physician before calling the stroke team.Copyright � 2013 National Stroke Association. All rights reserved.

METHODS: This is an analysis of data from consecutive patients seen by the National Institutes of Health Stroke Program over 10 years. Data were collected prospectively as a quality improvement initiative. Patients with a cerebrovascular event or a stroke mimic were compared with the Student t or Pearson chi-square test as appropriate, and logistic regression was done to identify independent predictors.

RESULTS: The analysis included 8187 patients: 30% had a stroke mimic. Patients with a stroke mimic were younger, and the proportion of patients with a stroke mimic was higher among women, patients without any risk factors, those seen as a code stroke or who arrived to the emergency department via personal vehicle, and those who had the onset of symptoms while inpatients. The proportion of patients with a stroke mimic was marginally higher among African-Americans than Caucasians. Factors associated with the greatest odds of having a stroke mimic in the logistic regression were lack of a history of hypertension, atrial fibrillation or hyperlipidemia.

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