title: Predictors of acute stroke mimics in 8187 patients referred to a stroke service.
abstract: BACKGROUND
  Some patients seen by a stroke team do not have cerebrovascular disease but a condition that mimics stroke. The purpose of this study was to determine the rate and predictors of stroke mimics in a large sample.
  
  
  METHODS
  This is an analysis of data from consecutive patients seen by the National Institutes of Health Stroke Program over 10 years. Data were collected prospectively as a quality improvement initiative. Patients with a cerebrovascular event or a stroke mimic were compared with the Student t or Pearson chi-square test as appropriate, and logistic regression was done to identify independent predictors.
  
  
  RESULTS
  The analysis included 8187 patients: 30% had a stroke mimic. Patients with a stroke mimic were younger, and the proportion of patients with a stroke mimic was higher among women, patients without any risk factors, those seen as a code stroke or who arrived to the emergency department via personal vehicle, and those who had the onset of symptoms while inpatients. The proportion of patients with a stroke mimic was marginally higher among African-Americans than Caucasians. Factors associated with the greatest odds of having a stroke mimic in the logistic regression were lack of a history of hypertension, atrial fibrillation or hyperlipidemia.
  
  
  CONCLUSIONS
  One third of the patients seen by a stroke team over 10 years had a stroke mimic. Factors associated with a stroke mimic may be ascertained by an emergency physician before calling the stroke team.
authors.affiliation: Section on Stroke Diagnostics and Therapeutics, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland; Johns Hopkins Community Physicians, Bethesda, Maryland; Suburban Hospital Stroke Center, Bethesda, Maryland. Electronic address: jmerino3@jhmi.edu.
authors.forename: José G
authors.initials: JG
authors.lastname: Merino
authors.forename: Marie
authors.initials: M
authors.lastname: Luby
authors.forename: Richard T
authors.initials: RT
authors.lastname: Benson
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Davis
authors.forename: Amie W
authors.initials: AW
authors.lastname: Hsia
authors.forename: Lawrence L
authors.initials: LL
authors.lastname: Latour
authors.forename: John K
authors.initials: JK
authors.lastname: Lynch
authors.forename: Steven
authors.initials: S
authors.lastname: Warach
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009316:National Institutes of Health (U.S.); D016017:Odds Ratio; D010348:Patient Care Team; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis* / Q000208:ethnology; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Acute stroke; diagnosis; emergency medicine; stroke mimics