Assessment of hospital admission surveillance of stroke in a metropolitan community.
A system of hospital admission surveillance, developed to facilitate the communitywide study of incident stroke, has been evaluated in Monroe County, New York. Of 1604 consecutive patients admitted to the county's seven acute hospitals with a stroke-related diagnosis, 903 were subsequently confirmed as strokes, (predictive value positive = 56%). Among the 701 false positives, 52% were due to TIA or carotid stenosis, while 48% were due to other conditions mimicking stroke. Sensitivity was 68%. Among missed stroke cases 42% were admitted with non stroke-related diagnoses; 25% occurred in hospital; and 32% were missed for clerical reasons. Predictive value positive and sensitivity rates of admission screening were not significantly affected by patient age or sex. In conclusion, admission surveillance has identified a representative sample of hospitalized strokes in a practical and timely manner for studying factors effecting stroke incidence and outcomes on a communitywide basis.
D000368:Aged; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D003955:Diagnostic Tests, Routine / Q000592:standards*; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D006764:Hospitals, Community; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis; D008875:Middle Aged; D009518:New York; D011336:Probability