L M Gibson1, W Whiteley. 1. Department of Clinical Radiology, Western General Hospital, Edinburgh EH4 2XU, UK. lornagibson1@nhs.net
Abstract
BACKGROUND: We aimed to determine the proportion of patients who had suffered a stroke and compare this to those patients with suspected stroke, and the range of differential diagnosis for suspected stroke. METHODS: We searched for prospective studies of suspected stroke in electronic databases and our personal files. We undertook a meta-analysis of these studies, aimed at determining the proportions of patients with confirmed stroke in different settings. RESULTS: We identified 29 studies involving 8,839 patients: 13 studies were from emergency departments, five from stroke units or transient ischaemic attack (TIA) clinics, three from primary care, three from ambulance services and five were unspecified. About three-quarters (74% [95% confidence interval (CI): 66 to 83%]) of patients had a diagnosis of stroke, though there was significant heterogeneity in this estimate. The five most frequent non-stroke diagnoses were seizure, syncope, sepsis, migraine and brain tumours. CONCLUSION: Patients who had not had a stroke accounted for a significant proportion of people referred to stroke services. Expertise in the differential diagnoses of stroke is needed in order to manage the patients at the point of referral.
BACKGROUND: We aimed to determine the proportion of patients who had suffered a stroke and compare this to those patients with suspected stroke, and the range of differential diagnosis for suspected stroke. METHODS: We searched for prospective studies of suspected stroke in electronic databases and our personal files. We undertook a meta-analysis of these studies, aimed at determining the proportions of patients with confirmed stroke in different settings. RESULTS: We identified 29 studies involving 8,839 patients: 13 studies were from emergency departments, five from stroke units or transient ischaemic attack (TIA) clinics, three from primary care, three from ambulance services and five were unspecified. About three-quarters (74% [95% confidence interval (CI): 66 to 83%]) of patients had a diagnosis of stroke, though there was significant heterogeneity in this estimate. The five most frequent non-stroke diagnoses were seizure, syncope, sepsis, migraine and brain tumours. CONCLUSION:Patients who had not had a stroke accounted for a significant proportion of people referred to stroke services. Expertise in the differential diagnoses of stroke is needed in order to manage the patients at the point of referral.
Authors: Lisa Shaw; Sara Graziadio; Clare Lendrem; Nicholas Dale; Gary A Ford; Christine Roffe; Craig J Smith; Philip M White; Christopher I Price Journal: Diagn Progn Res Date: 2021-05-20
Authors: Alberto Spalice; Francesca Del Balzo; Laura Papetti; Anna Maria Zicari; Enrico Properzi; Francesca Occasi; Francesco Nicita; Marzia Duse Journal: Ital J Pediatr Date: 2016-04-26 Impact factor: 2.638