"Encephalopathy Only Stroke Codes" (EoSC) Rarely Result in Stroke as Final Diagnosis.
"Encephalopathy Only Stroke Codes" (EoSC) Rarely Result in Stroke as Final Diagnosis.
复制标题
“仅脑病中风代码”(EoSC) 很少会导致中风作为最终诊断。
DOI：
10.1155/2019/2105670
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发表时间：
2019
影响因子：
1.5
通讯作者：
Meyer,BrettC
中科院分区：
文献类型：
--
作者：
Chen,PatrickM;Meyer,DawnM;Claycomb,Robert;Agrawal,Kunal;Meyer,BrettC
由孤立性脑病引起的卒中代码通常导致非卒中的最终诊断，但需要密集的卒中中心资源。我们评估了“仅脑病卒中代码（EoSC）”导致真正卒中（EoSC CVA+）最终诊断的可能性。在2004年至2016年的前瞻性卒中代码登记研究中分析了3860例患者。使用标准和探索性定义定义EoSC。定义1包括EoSC患者作为卒中代码，其中NIHSS对于NIHSS问题（问题la、1b和lc）为非零，但其余NIHSS为零。定义2包括相同的定义，但允许运动问题的对称配对（5a/5 b，6a/6 b，或问题4评分3）。评估各组最终诊断为斯托克（EoSC CVA+）或非卒中（EoSC CVA-）。EoSC占总卒中代码的60/3860（1.55%）。在所有卒中代码的5/3860（0.13%）、EoSC卒中代码的5/60（8.33%）和所有卒中的5/1514（0.33%）中发现EoSC CVA+。对于定义2，EoSC占总卒中代码的96/3860（2.5%）。在所有卒中代码的9/3860（0.23%）、EoSC卒中代码的9/96（9.38%）和所有卒中的9/1514（0.59%）中发现EoSC CVA+。在多变量logistic回归分析中，糖尿病是卒中的最高预测因子（p=0.05）。仅脑病卒中代码很少导致真正最终诊断为卒中（EoSC CVA+）的病例，占所有卒中代码的0.1 - 0.2%和EoSC卒中代码的8 - 9%。这可能对未来动员有限的急性卒中代码资源具有重要意义。
Stroke codes prompted by isolated encephalopathy often result in nonstroke final diagnoses but require intensive stroke center resources. We assessed the likelihood of “Encephalopathy only Stroke Codes (EoSC)” resulting in a true stroke (EoSC CVA+) final diagnosis. 3860 patients were analyzed in a prospective stroke code registry from 2004 to 2016. EoSC was defined using a standard and an exploratory definition. Definition 1 included EoSC patients as stroke codes where NIHSS was nonzero for LOC questions (questions la, 1b, and lc) but remainder of the NIHSS was zero. Definition 2 included the same definition but allowed symmetric pairings on motor questions (5a/5b, 6a/6b, or Question 4 scoring a 3). Groups were assessed for final diagnosis of stoke (EoSC CVA+) or not stroke (EoSC CVA‐). EoSC accounted for 60/3860 (1.55%) of total stroke codes. EoSC CVA+ was found in 5/3860 (0.13%) of all stroke codes, 5/60 (8.33%) of EoSC stroke codes, and 5/1514 (0.33%) of all strokes. For Definition 2, EoSC accounted for 96/3860 (2.5%) of total stroke codes. EoSC CVA+ was found in 9/3860 (0.23%) of all stroke codes, 9/96 (9.38%) of EoSC stroke codes, and 9/1514 (0.59%) of all strokes. On multivariable logistic regression analysis, diabetes was the highest predictor of stroke (p=0.05). Encephalopathy only Stroke Codes only rarely result in cases with a true final diagnosis of stroke (EoSC CVA+), accounting for 0.1‐0.2% of all stroke codes and 8‐9% of EoSC stroke codes. This may have important significance for mobilization of limited acute stroke code resources in the future.