Emergency physician's diagnosis of stroke subtype: an accuracy study
Arq. neuropsiquiatr
;
56(3B): 523-7, set. 1998. tab
Article
Dans Anglais
| LILACS
| ID: lil-220873
ABSTRACT
Objective:
To evaluate the accuracy of clinical unstructured and structured diagnosis of acute stroke subtypes - cerebral haemorrhage (CH), cerebral infarction (CI), subarachnoid haemorrhage (SAH).Methods:
Sixty consecutive patients with acute atroke admitted to the Emergency Ward of a Brazilian University Hospital were examined by emergency physicians and computerised tomography (CT). We also compared it (physycian's unstructured diagnosis) to two published clinical scoring (structured diagnosis - Guy's Hospital and Siriraj Hospital) applied to three other populations - regarding the operational characteristics of the tests.Results:
In our personal data, among 9 variables that could discriminate CH and CI, three have statistically significant difference (p<0.05) headache (p=0.0002) and vomiting (p=0.02) occurred more frequently in CH patients, but previous stroke in those with CI (p=0.04). Unstructured diagnosis proved valid for SAH, with a +LHR=39.7; and to a smaller degree for CI (-LHR=0.1). However, it exhibited low sensitivity for the diagnosis of CH. Structured tests (Guy's Hospital and Siriraj Hospital) also failed to confidently diagnose stroke subtypes, especially CH.Conclusions:
Both clinical diagnosis (made be emergency physicians) and the available diagnostic tests fail to confidently discriminate CH and CI.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Angiopathies intracrâniennes
/
Services des urgences médicales
Type d'étude:
Etude diagnostique
/
Étude observationnelle
/
Étude de prévalence
/
Facteurs de risque
Limites du sujet:
Adulte
/
Femelle
/
Humains
langue:
Anglais
Texte intégral:
Arq. neuropsiquiatr
Thème du journal:
Neurologie
/
Psychiatrie
Année:
1998
Type:
Article
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