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Clinical Differences Between Stroke and Stroke Mimics in Code Stroke Patients

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Author(s)
Taekwon KimHan-Yeong JeongGil Joon Suh
Keimyung Author(s)
Kim, Tae Kwon
Department
Dept. of Emergency Medicine (응급의학)
Journal Title
J Korean Med Sci
Issued Date
2022
Volume
37
Issue
7
Keyword
Stroke MimicsStrokeCode StrokeEmergency Department
Abstract
Background:
The code stroke system is designed to identify stroke patients who may benefit from reperfusion therapy. It is essential for emergency physicians to rapidly distinguish true strokes from stroke mimics to activate code stroke. This study aimed to investigate the clinical and neurological characteristics that can be used to differentiate between stroke and stroke mimics in the emergency department (ED).

Methods:
We conducted a retrospective observational study of code stroke patients in the ED from January to December 2019. The baseline characteristics and the clinical and neurological features of stroke mimics were compared with those of strokes.

Results:
A total of 409 code stroke patients presented to the ED, and 125 (31%) were diagnosed with stroke mimics. The common stroke mimics were seizures (21.7%), drug toxicity (12.0%), metabolic disorders (11.2%), brain tumors (8.8%), and peripheral vertigo (7.2%). The independent predictors of stroke mimics were psychiatric disorders, dizziness, altered mental status, and seizure-like movements, while current smoking, elevated systolic blood pressure, atrial fibrillation on the initial electrocardiogram, hemiparesis as a symptom, and facial palsy as a sign suggested a stroke. In addition, the likelihood of a stroke in code stroke patients tended to increase as the number of accompanying deficits increased from the following set of seven focal neurological deficits: hemiparesis (or upper limb monoparesis), unilateral limb sensory change, facial palsy, dysarthria, aphasia (or neglect), visual field defect, and oculomotor disorder (P < 0.001).

Conclusion:
Some clinical and neurological characteristics have been identified to help differentiate stroke mimics from true stroke. In particular, the likelihood of stroke tended to increase as the number of accompanying focal neurological deficits increased.
Keimyung Author(s)(Kor)
김태권
Publisher
School of Medicine (의과대학)
Citation
Taekwon Kim et al. (2022). Clinical Differences Between Stroke and Stroke Mimics in Code Stroke Patients. J Korean Med Sci, 37(7), e54. doi: 10.3346/jkms.2022.37.e54
Type
Article
ISSN
1598-6357
Source
https://jkms.org/search.php?where=aview&id=10.3346/jkms.2022.37.e54&code=0063JKMS&vmode=FULL
DOI
10.3346/jkms.2022.37.e54
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44082
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학)
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