Sahlgrenska University Hospital and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Acta Neurol Scand. 2019 Aug;140(2):93-99. doi: 10.1111/ane.13107. Epub 2019 May 9.
Symptoms related to stroke diverge and may mimic many other conditions.
To evaluate clinical findings among patients with a clinical suspicion of stroke in a prehospital setting and find independent predictors of a final diagnosis of stroke or transient ischemic attack (TIA).
An observational multicenter study includes nine emergency hospitals in western Sweden. All patients transported to hospital by ambulance and in whom a suspicion of stroke was raised by the emergency medical service clinician before hospital admission during a four-month period were included.
Of 1081 patients, a diagnosis of stroke was confirmed at hospital in 680 patients (63%), while 69 (6%) were diagnosed as TIA and 332 patients (31%) received other final diagnoses. In a multiple logistic regression analysis, factors independently associated with a final diagnosis of stroke or TIA were increasing age, odds ratio (OR) per year: 1.02, P = 0.007, a history of myocardial infarction (OR: 1.77, P = 0.01), facial droop (OR: 2.81, P < 0.0001), arm weakness (OR: 2.61, P < 0.0001), speech disturbance (OR: 1.92, P < 0.0001), and high systolic blood pressure (OR: 1.50, P = 0.02), while low oxygen saturation was significantly associated with other diagnoses (OR: 0.41, P = 0.007). More than half of all patients among patients with both stroke/TIA and other final diagnoses died during the five-year follow-up.
Seven factors including the three symptoms included in the Face Arm Speech Test were significantly associated with a final diagnosis of stroke or TIA in a prehospital assessment of patients with a suspected stroke.
与中风相关的症状各不相同，可能类似于许多其他病症。
评估在院前环境中具有中风临床疑似症状的患者的临床发现，并找到中风或短暂性脑缺血发作（TIA）的最终诊断的独立预测因素。
这是一项观察性多中心研究，包括瑞典西部的 9 家急诊医院。所有在入院期间通过救护车送往医院的患者，且在入院前由急救医疗服务临床医生怀疑患有中风，均纳入研究。
在 1081 名患者中，有 680 名（63%）在医院确诊为中风，69 名（6%）被诊断为 TIA，332 名（31%）患者最终诊断为其他疾病。在多变量逻辑回归分析中，与中风或 TIA 最终诊断相关的独立因素为年龄增长，每年的优势比（OR）为 1.02，P=0.007；心肌梗死史（OR：1.77，P=0.01），面瘫（OR：2.81，P<0.0001），手臂无力（OR：2.61，P<0.0001），言语障碍（OR：1.92，P<0.0001）和高收缩压（OR：1.50，P=0.02），而低血氧饱和度与其他诊断显著相关（OR：0.41，P=0.007）。在具有中风/TIA 和其他最终诊断的患者中，超过一半的患者在五年随访期间死亡。
在对疑似中风患者的院前评估中，包括在面部手臂言语测试中包含的三个症状在内的七个因素与中风或 TIA 的最终诊断显著相关。
