title: Variables That Best Differentiate In-Patient Acute Stroke from Stroke-Mimics with Acute Neurological Deficits.
abstract: Introduction. Strokes and stroke-mimics have been extensively studied in the emergency department setting. Although in-hospital strokes are less studied in comparison to strokes in the emergency department, they are a source of significant direct and indirect costs. Differentiating in-hospital strokes from stroke-mimics is important. Thus, our study aimed to identify variables that can differentiate in-hospital strokes from stroke-mimics.Methods. We present here a retrospective analysis of 93 patients over a one-year period (2009 to 2010), who were evaluated for a concern of in-hospital strokes.Results. About two-thirds (57) of these patients were determined to have a stroke, and the remaining (36) were stroke-mimics. Patients with in-hospital strokes were more likely to be obese (p= 0.03), have been admitted to the cardiology service (p= 0.01), have atrial fibrillation (p= 0.03), have a weak hand or hemiparesis (p= 0.03), and have a prior history of stroke (p= 0.05), whereas, when the consults were called for "altered mental status" but no other deficits (p< 0.0001), it is likely a stroke-mimic.Conclusion. This study demonstrates that in-hospital strokes are a common occurrence, and knowing the variables can aid in their timely diagnosis and treatment.
authors.affiliation: Department of Neurology, University of Missouri, Columbia, 5 Hospital Drive, CE 540, Columbia, MO 65211, USA.
authors.forename: P
authors.initials: P
authors.lastname: Natteru
authors.affiliation: Department of Emergency Medicine, University of Missouri, Columbia, Columbia, MO, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Mohebbi
authors.affiliation: Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.
authors.forename: P
authors.initials: P
authors.lastname: George
authors.affiliation: Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.
authors.forename: D
authors.initials: D
authors.lastname: Wisco
authors.affiliation: Akron General Hospital, 3562 Ridge Park Dr, Akron, OH 44333, USA.
authors.forename: J
authors.initials: J
authors.lastname: Gebel
authors.affiliation: Department of Neurology, University of Missouri, Columbia, 5 Hospital Drive, CE 540, Columbia, MO 65211, USA.
authors.forename: C R
authors.identifier: 0000-0002-9386-7791
authors.initials: CR
authors.lastname: Newey