title: Non-stroke admissions to a hyperacute stroke unit.
abstract: A significant proportion of patients presenting to hyperacute stroke units (HSUs) are diagnosed with non-stroke (NS). This study aimed to assess the rate and diagnoses of NS patients admitted to a HSU and the implications for clinical service provision. Admissions to the HSU at the Southern General Hospital, Glasgow, were retrospectively assessed (March 2007-September 2007). NS patients were identified by two parallel ascertainment methods and NS diagnosis was confirmed by case-note and discharge letter review. Of 375 presentations, 116 (31%) were due to NS. NS diagnosis was more likely for local referrals than from regional hospitals (41% versus 19%; P = 0.0002). Compared with stroke/transient ischaemic attack patients, NS patients were significantly younger, more likely to have an magnetic resonance imaging (MRI) scan and had a shorter length of hospital stay. Common NS diagnoses were migraine (22%), functional neurological disorder (14%), syncope (12%) and seizure (6%). NS patients who had an MRI scan were more likely to have a length of stay ≥2 days (75% versus 53%; P = 0.03). NS makes up one-third of acute stroke-like presentations with a high frequency of neurological conditions. NS patients tend to be younger and require significant investigation. The increased use of MRI and neurological services has implications for providing a hyperacute stroke service.
authors.affiliation: Department of Neurology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK. johnreid1@nhs.net
authors.forename: J M
authors.initials: JM
authors.lastname: Reid
authors.forename: Y
authors.initials: Y
authors.lastname: Currie
authors.forename: T
authors.initials: T
authors.lastname: Baird
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D020330:Bell Palsy / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000592:standards*; D012189:Retrospective Studies; D012606:Scotland; D012640:Seizures / Q000175:diagnosis; D020521:Stroke / Q000175:diagnosis*; D019462:Syncope, Vasovagal / Q000175:diagnosis