BACKGROUND: Acute stroke is a time-sensitive condition in which rapid diagnosis must be made in order for thrombolytic treatment to be administered. A certain proportion of patients who receive thrombolysis will be found on further evaluation to have a diagnosis other than stroke, so-called "stroke mimics." Little is known about the role of language discordance in the emergency department diagnosis of acute ischemic stroke. METHODS: This is a retrospective analysis of all acute ischemic stroke patients who received IV tissue plasminogen activator (tPA) in our emergency department between July 2011 and December 2015. Baseline characteristics, patient language, and final diagnosis were compared between encounters in which the treating neurologist and patient spoke the same language (concordant cases) and encounters in which they did not (discordant cases). RESULTS: A total of 350 patients received IV tPA during the study period. English was the primary language for 52.6%, Spanish for 44.9%, and other languages for 2.6%; 60.3% of cases were classified as language concordant and 39.7% as discordant. We found no significant difference in the proportion of stroke mimics in the language concordant compared to discordant groups (16.6% vs 9.4%, p = 0.06). Similarly, the proportion of stroke mimics did not differ between English- and Spanish-speaking patients (15.8% vs 11.5%, p = 0.27). CONCLUSIONS: Language discordance was not associated with acute stroke misdiagnosis among patients treated with IV tPA. Prospective evaluation of communication during acute stroke encounters is needed to gain clarity on the role of language discordance in acute stroke misdiagnosis.
BACKGROUND:Acute stroke is a time-sensitive condition in which rapid diagnosis must be made in order for thrombolytic treatment to be administered. A certain proportion of patients who receive thrombolysis will be found on further evaluation to have a diagnosis other than stroke, so-called "stroke mimics." Little is known about the role of language discordance in the emergency department diagnosis of acute ischemic stroke. METHODS: This is a retrospective analysis of all acute ischemic strokepatients who received IV tissue plasminogen activator (tPA) in our emergency department between July 2011 and December 2015. Baseline characteristics, patient language, and final diagnosis were compared between encounters in which the treating neurologist and patient spoke the same language (concordant cases) and encounters in which they did not (discordant cases). RESULTS: A total of 350 patients received IV tPA during the study period. English was the primary language for 52.6%, Spanish for 44.9%, and other languages for 2.6%; 60.3% of cases were classified as language concordant and 39.7% as discordant. We found no significant difference in the proportion of stroke mimics in the language concordant compared to discordant groups (16.6% vs 9.4%, p = 0.06). Similarly, the proportion of stroke mimics did not differ between English- and Spanish-speaking patients (15.8% vs 11.5%, p = 0.27). CONCLUSIONS: Language discordance was not associated with acute stroke misdiagnosis among patients treated with IV tPA. Prospective evaluation of communication during acute stroke encounters is needed to gain clarity on the role of language discordance in acute stroke misdiagnosis.
Authors: Georgios Tsivgoulis; Ramin Zand; Aristeidis H Katsanos; Nitin Goyal; Ken Uchino; Jason Chang; Efthimios Dardiotis; Jukka Putaala; Anne W Alexandrov; Marc D Malkoff; Andrei V Alexandrov Journal: Stroke Date: 2015-03-19 Impact factor: 7.914
Authors: Sanne M Zinkstok; Stefan T Engelter; Henrik Gensicke; Philippe A Lyrer; Peter A Ringleb; Ville Artto; Jukka Putaala; Elena Haapaniemi; Turgut Tatlisumak; Yaohua Chen; Didier Leys; Hakan Sarikaya; P Michel; Céline Odier; Jörg Berrouschot; Marcel Arnold; Mirjam R Heldner; Andrea Zini; Valentina Fioravanti; Visnja Padjen; Ljiljana Beslac-Bumbasirevic; Alessandro Pezzini; Yvo B Roos; Paul J Nederkoorn Journal: Stroke Date: 2013-02-26 Impact factor: 7.914
Authors: Ava John-Baptiste; Gary Naglie; George Tomlinson; Shabbir M H Alibhai; Edward Etchells; Angela Cheung; Moira Kapral; Wayne L Gold; Howard Abrams; Maria Bacchus; Murray Krahn Journal: J Gen Intern Med Date: 2004-03 Impact factor: 5.128
Authors: Sara K Rostanski; Joshua Stillman; Olajide Williams; Randolph S Marshall; Shadi Yaghi; Joshua Z Willey Journal: Neurohospitalist Date: 2016-04-14
Authors: Anika L Hines; Roxanne M Andrews; Ernest Moy; Marguerite L Barrett; Rosanna M Coffey Journal: Int J Environ Res Public Health Date: 2014-12-12 Impact factor: 3.390
Authors: Sara K Rostanski; Benjamin R Kummer; Eliza C Miller; Randolph S Marshall; Olajide Williams; Joshua Z Willey Journal: Neurohospitalist Date: 2018-09-27