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

José G. Merino, Marie Luby, Richard T. Benson, Lisa A. Davis, Amie W. Hsia, Lawrence L. Latour, John K. Lynch, Steven Warach

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

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. 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. 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.

Original languageEnglish (US)
JournalJournal of Stroke and Cerebrovascular Diseases
Volume22
Issue number8
DOIs
StatePublished - Nov 2013

Fingerprint

Stroke
Logistic Models
Cerebrovascular Disorders
National Institutes of Health (U.S.)
Chi-Square Distribution
Quality Improvement
Hyperlipidemias
African Americans
Atrial Fibrillation
Hospital Emergency Service
Inpatients
Emergencies
Students
Hypertension
Physicians

Keywords

  • Acute stroke
  • diagnosis
  • emergency medicine
  • stroke mimics

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Predictors of acute stroke mimics in 8187 patients referred to a stroke service. / Merino, José G.; Luby, Marie; Benson, Richard T.; Davis, Lisa A.; Hsia, Amie W.; Latour, Lawrence L.; Lynch, John K.; Warach, Steven.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 22, No. 8, 11.2013.

Research output: Contribution to journalArticle

Merino, José G. ; Luby, Marie ; Benson, Richard T. ; Davis, Lisa A. ; Hsia, Amie W. ; Latour, Lawrence L. ; Lynch, John K. ; Warach, Steven. / Predictors of acute stroke mimics in 8187 patients referred to a stroke service. In: Journal of Stroke and Cerebrovascular Diseases. 2013 ; Vol. 22, No. 8.
@article{0c79cb8ab9a94c00b1daca69587663eb,
title = "Predictors of acute stroke mimics in 8187 patients referred to a stroke service",
abstract = "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. 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. 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.",
keywords = "Acute stroke, diagnosis, emergency medicine, stroke mimics",
author = "Merino, {Jos{\'e} G.} and Marie Luby and Benson, {Richard T.} and Davis, {Lisa A.} and Hsia, {Amie W.} and Latour, {Lawrence L.} and Lynch, {John K.} and Steven Warach",
year = "2013",
month = "11",
doi = "10.1016/j.jstrokecerebrovasdis.2013.04.018",
language = "English (US)",
volume = "22",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Predictors of acute stroke mimics in 8187 patients referred to a stroke service

AU - Merino, José G.

AU - Luby, Marie

AU - Benson, Richard T.

AU - Davis, Lisa A.

AU - Hsia, Amie W.

AU - Latour, Lawrence L.

AU - Lynch, John K.

AU - Warach, Steven

PY - 2013/11

Y1 - 2013/11

N2 - 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. 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. 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.

AB - 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. 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. 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.

KW - Acute stroke

KW - diagnosis

KW - emergency medicine

KW - stroke mimics

UR - http://www.scopus.com/inward/record.url?scp=84885363122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885363122&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2013.04.018

DO - 10.1016/j.jstrokecerebrovasdis.2013.04.018

M3 - Article

VL - 22

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 8

ER -