[Stroke management in a general internal medicine department: results of a survey regarding practice].
OBJECTIVE
The incidence of strokes in the general population and the insufficient numbers of centers specialized in their management has led to the increased hospitalization of patients in general, internal medicine departments. The prognosis for patients is related to the relevance of the initial diagnostic and therapeutic measures. To optimize management of stroke patients outside of specialized units, a survey concerning practice was conducted in internal medicine departments in western France, and a meeting was held to define guidelines.


METHODS
Data sheets were mailed to practitioners in internal medicine departments prior to the survey. The following data were recorded for each patient hospitalized during the two-week study: age, sex, clinical characteristics of stroke, risk factors, investigations performed, and initial and subsequent medical management. On the basis of the results, management guidelines were considered and defined.


RESULTS
Patients hospitalized for a stroke in internal medicine departments have a similar profile to those hospitalized in neurology departments. CT-scan and EKG recordings were performed in most patients whereas other investigations (cervical ultrasound, echocardiography, MRI) were used less frequently. The use of rehabilitation and therapeutic strategies for secondary stroke prevention were not always performed according to current guidelines.


CONCLUSIONS
Internal medicine departments are frequently involved in the care of stroke patients. The present study of clinical practice may help to improve stroke management in these non-specialized departments.
Guillon
B
B
Service de neurologie, hôpital Laënnec, CHU, 44093 Nantes, France. benoit.guillon@chu-nantes.fr
Planchon
B
B
Woimant
F
F
Magne
C
C
Barrier
J H
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000628:therapy; D003625:Data Collection; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005602:France; D006748:Hospital Departments; D006801:Humans; D006973:Hypertension / Q000150:complications; D007388:Internal Medicine; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin