Ability of emergency physicians to detect early ischemic changes of acute ischemic stroke on cranial computed tomography.
OBJECTIVE
The objective of this study was to evaluate the ability of emergency physicians (EPs) to diagnose early ischemic changes due acute ischemic stroke on cranial computed tomography (CT).


METHODS
Three EPs interpreted CT scans obtained within 3 h of symptom onset in 50 patients with acute stroke. The CT scans were interpreted by the EPs and compared to official neuroradiologist reports as a gold standard. ĸ statistics were calculated to determine agreement among the three readers. Sensitivities and specificities were analyzed for each reader.


RESULTS
The EPs' sensitivities were 50, 45.5, and 45.5%, and specificities were 64.3, 82.1, and 64.3%, respectively. Focal parenchymal hypodensity was the criterion for which the EPs were the most sensitive (77.3%). The ability of EPs to recognize early ischemic changes on CT scans in acute ischemic stroke was moderate based on sensitivities.


CONCLUSIONS
Based on this study, EPs must be trained especially for recognizing early ischemic changes in acute ischemic stroke to improve their accuracy of interpretation.
Department of Emergency Medicine, Izmir Ataturk Research and Training Hospital, Izmir, Turkey. erolerdenun @ yahoo.com
Erden Erol
EE
Ünlüer
Erdem
E
Yaka
Galip
G
Akhan
Önder
Ö
Limon
Pinar Hanife
PH
Kara
Özcan
Ö
Yavaşi
Nergiz
N
Vandenberk
Yasemin Ece
YE
Nazli
Kürşad
K
Kutluk
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D016001:Confidence Intervals; D018450:Disease Progression; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity; D012886:Skull / Q000000981:diagnostic imaging* / Q000473:pathology; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D013997:Time Factors