Jalali Rakesh, Bieniecka Aleksandra, Jankowski Marek, Michel Patryk Stanisław, Popielarczyk Marta, Majewski Mariusz Krzysztof, Zwiernik Jacek, Harazny Joanna Maria
Department of Emergency Medicine, School of Medicine, University of Warmia and Mazury, 10-719 Olsztyn, Poland.
Students' Research Group, Department of Human Physiology and Pathophysiology, School of Medicine, University of Warmia and Mazury, 10-719 Olsztyn, Poland.
J Pers Med. 2024 Sep 11;14(9):964. doi: 10.3390/jpm14090964.
Stroke is one of the most misdiagnosed conditions that causes serious medical disabilities. Its early and accurate diagnosis by the emergency team is crucial for the patient's survival. This study aimed to determine the percentage of brain strokes incorrectly diagnosed by paramedic teams and to analyze the factors influencing incorrect diagnoses.
The data of 103 patients, mean age of 68.4 ± 14.96 years, admitted in 2019 to hospital emergency departments of the two hospitals in Olsztyn, Poland, were analyzed retrospectively. All patient data were obtained from their information cards. The parameters of the patients misdiagnosed and accurately diagnosed by paramedics were analyzed with Odds Ratio (OR) calculations using IBM SPSS version 23 software.
Stroke and transient ischemic attack were recognized in 77 cases (74.8%). In 26 patients (25.2%), the diagnosis made in the ambulance differed from that made in the hospital ward. The analysis of the Odds Ratio (OR) has shown that typical stroke risk factors, if present in a patient, facilitate the correct diagnosis. The greatest source of misdiagnosis of stroke by the paramedic team was the lack of hemiplegia (OR = 6.0).
The absence of typical stroke risk factors and neurological stroke symptoms, such as smoking, hemiplegia, aphasia, hypercholesterolemia, arrhythmia, diabetes or a drooping corner of the mouth, constitutes a high risk of misdiagnosing stroke by the paramedic team.
中风是最容易被误诊的疾病之一，会导致严重的医疗残疾。急救团队对其进行早期准确诊断对患者的生存至关重要。本研究旨在确定护理人员团队误诊的脑中风百分比，并分析影响误诊的因素。
回顾性分析了2019年波兰奥尔什丁两家医院急诊科收治的103例患者的数据，患者平均年龄为68.4±14.96岁。所有患者数据均从其信息卡中获取。使用IBM SPSS 23版软件通过比值比（OR）计算分析护理人员误诊和准确诊断患者的参数。
77例（74.8%）患者被诊断为中风和短暂性脑缺血发作。26例（25.2%）患者在救护车上做出的诊断与在医院病房做出的诊断不同。比值比（OR）分析表明，如果患者存在典型的中风危险因素，则有助于正确诊断。护理人员团队误诊中风的最大原因是缺乏偏瘫（OR = 6.0）。
缺乏典型的中风危险因素和神经中风症状，如吸烟、偏瘫、失语、高胆固醇血症、心律失常、糖尿病或嘴角下垂，会使护理人员团队误诊中风的风险很高。
