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Stroke in the ER - a prospective cohort study of patients suspected of stroke / TIA

Authors
Journal
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine
1757-7241
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
18
Identifiers
DOI: 10.1186/1757-7241-18-s1-p30
Keywords
  • Poster Presentation
Disciplines
  • Medicine

Abstract

Stroke in the ER - a prospective cohort study of patients suspected of stroke / TIA POSTER PRESENTATION Open Access Stroke in the ER - a prospective cohort study of patients suspected of stroke / TIA Malene Martini Clausen*, Julie Blockmann, Thomas Andersen Schmidt From Danish Society for Emergency Medicine: Research Symposium 2010 Roskilde, Denmark. 20-21 May 2010 Background Patients suspected of having a stroke or transitory ischemic attack (TIA) require acute and accurate assess- ment in the ER in order to initiate immediate and pre- ventive treatment. The clinical diagnosis is complicated by stroke mimics and poor reliability when based solely on history and physical examination. Methods The objective was to investigate how many patients sus- pected of stroke/TIA on pre-hospital evaluation, received this as the final diagnosis following assessment in the ER and finally by neurologists and CTC. For four weeks, data was prospectively collected and reviewed. Results Forty-five patients were included (n = 45) and received the following diagnosis: ischemic stroke/TIA 55.6% (n = 25), hemorrhagic stroke 6.7% (n = 3), other 37.8% (n = 17). Ninety-one percent (n = 41) were admitted for further examination. Eighty percent (n = 20) of patients with validated stroke were aged 61-90 years. In 91% of cases with suspected stroke, the tentative diagnosis was sustained in the ER. Of the admitted patients (n = 41), 68.3% received stroke as a final diagnosis. All patients not deemed to have stroke (31.7%) were diagnosed with stroke mimics. Of all strokes (n = 28) 89.3% were ischemic and 10.7% were hemorrhagic. In the age group 85-89 years, 50% had suffered a prior stroke. Eighty per- cent of admitted patients younger than 50, were diag- nosed with various stroke mimics. Conclusion Our results correlate well with previously reported dis- tributions of ischemic versus hemorrhagic stroke. Further, they confirm prior stroke and age as important risk factors. Regarding “unnecessary” admissions

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