Prevalence and factor associated with acute ischemic stroke at emergency department
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Abstract
Background: The failure to recognize an ischemic stroke in the emergency department is a missed opportunity for acute interventions and for prompt treatment with secondary prevention therapy, patients with missed strokes may not be monitored appropriately for neurological progression of stroke syndromes or stroke-related complications. Our aim is to study incidence and factors associated with missed diagnosis to enhance the patient care process.
Objectives: To study prevalence and factor associated with missed diagnosis of acute ischemic stroke at emergency department
Methods: A retrospective study collected data from electrical medical records of patient from stroke unit whose diagnosed acute ischemic stroke from emergency physician or neurologist at Chonburi Hospital from 1 October 2021 to 30 September 2022. The agreement of diagnosis from emergency physician and neurologist and analyzed using cohen’s kappa coefficient.
Factor associated with missed diagnosis of acute ischemic stroke were analyzed using multiple logistic regression. The significant level was 0.05 and all data were analyzed by STATA version 15
Results: A total of 252 patients were included in this study. The kappa agreement of diagnosis of acute ischemic stroke was 98.84%. Thirteen patients had a missed diagnosis. The chief compliant associated with missed diagnosis group were alteration of consciousness and dizziness, with odds ratios of 9.22 and 7.55, respectively, both statistically significant.
Conclusions: Alteration of consciousness and dizziness were associated with missed diagnosis of acute ischemic stroke.
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