Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland; Johns Hopkins Community Physicians, Bethesda, Maryland; Suburban Hospital Stroke Center, Bethesda, Maryland.
J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e397-403. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.018. Epub 2013 May 13.
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.
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.
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.
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.
有些接受卒中团队诊治的患者并非患有脑血管疾病，而是患有类似卒中的病症。本研究的目的是确定在大样本中卒中模拟病例的发生率和预测因素。
这是对国立卫生研究院卒中计划在 10 年间连续诊治的患者数据进行的分析。数据作为一项质量改进计划进行前瞻性收集。将患有脑血管事件或卒中模拟的患者与学生 t 检验或皮尔逊卡方检验进行比较，并进行逻辑回归以确定独立的预测因素。
分析纳入了 8187 例患者：30%为卒中模拟病例。卒中模拟患者更年轻，女性、无任何危险因素、因卒中代码或个人交通工具就诊、症状发生在住院期间的患者中，卒中模拟病例的比例更高。与白人相比，非裔美国人卒中模拟病例的比例略高。逻辑回归中与卒中模拟发生最大几率相关的因素是无高血压、心房颤动或高脂血症病史。
在 10 年间，卒中团队诊治的患者中约有 1/3为卒中模拟病例。在呼叫卒中团队之前，急诊医生可以通过确定这些因素来识别卒中模拟病例。
