Reliability of stroke diagnosis in emergency departments

Neurología : publicación oficial de la Sociedad Española de Neurología
E Martínez FernándezA Blanco Ollero

Abstract

According to the Spanish Stroke Health Care Plan and the Spanish Health National Service Stroke Strategy, thrombolysis should only be performed in hospitals with Stroke Units. However, the Andalusian Stroke Health Care Plan includes, within the list of services of the Stroke Team, the need to have a neurologist present for the performing of thrombolysis in local hospitals. The objective of this study is to evaluate whether emergency doctors are able to achieve a reliable diagnosis of stroke in order to safely perform thrombolysis. The diagnoses on hospital admission and discharge of all patients admitted for neurological reasons in 2006 in the community Hospital Infanta Elena (Huelva, Andalusia) were collected. The reliability of diagnosis performed by emergency doctors was analysed. A total of 655 patients were admitted to the hospital for neurological reasons, and 76% of them were diagnosed as strokes. The sensitivity of stroke diagnosis made by emergency doctors was very high (97%), but specificity and positive predictive value of that diagnosis was low (52% and 75%, respectively). To apply thrombolysis based of the diagnosis of a stroke by emergency doctors may subject a significant number of erroneously diagnosed patients ...Continue Reading

References

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Oct 18, 2008·Stroke; a Journal of Cerebral Circulation·Nils WahlgrenUNKNOWN Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy Investigators
Dec 18, 2010·Neurología : publicación oficial de la Sociedad Española de Neurología·J MasjuanC Tejero

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