A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate
Patients reaching the emergency department (ED) with symptoms of acute ischemic stroke (AIS) may be affected by a stroke mimics (SMs). A prompt clinical diagnosis could avoid unnecessary thrombolysis. We evaluated a new and rapid approach, the Santa Maria Nuova-Stroke Mimic (SMN-SM) scale, to impro...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
PAGEPress Publications
2024-02-01
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| Series: | Italian Journal of Medicine |
| Subjects: | |
| Online Access: | https://italjmed.org/index.php/ijm/article/view/1693 |
| _version_ | 1797335558413877248 |
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| author | Federico Moroni Vieri Vannucchi Costanza Vinci Simone Bianchi Alessandra Giuello Francesco Prosperi Iovi Michele Lanigra Angela Konze Giancarlo Landini |
| author_facet | Federico Moroni Vieri Vannucchi Costanza Vinci Simone Bianchi Alessandra Giuello Francesco Prosperi Iovi Michele Lanigra Angela Konze Giancarlo Landini |
| author_sort | Federico Moroni |
| collection | DOAJ |
| description |
Patients reaching the emergency department (ED) with symptoms of acute ischemic stroke (AIS) may be affected by a stroke mimics (SMs). A prompt clinical diagnosis could avoid unnecessary thrombolysis. We evaluated a new and rapid approach, the Santa Maria Nuova-Stroke Mimic (SMN-SM) scale, to improve a prompt clinical diagnosis. 340 consecutive patients admitted to the ED with suspected AIS were evaluated. The final diagnosis was: AIS in 267 (78,5%) and SMs in 73 (21,5%) patients. Multivariate logistical analysis showed that the following features – lack of facial paralysis, dizziness, migraine, seizure disorders, blood pressure <150, cognitive impairment, and female sex – were significantly more abundant in patients with SMs than in AIS. To each of these features we assigned a numerical score and we performed a receiver operating characteristic analysis. When the score of the scale was above 8 (cut-point), we obtained a specificity of 93% and a sensitivity of 56% for a SM diagnosis. Thus, the SMN-SM scale seems a rather useful tool to improve SMs diagnosis.
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| first_indexed | 2024-03-08T08:39:58Z |
| format | Article |
| id | doaj.art-0a7ebb5dc896431cbbbaa986b347eae0 |
| institution | Directory Open Access Journal |
| issn | 1877-9344 1877-9352 |
| language | English |
| last_indexed | 2024-03-08T08:39:58Z |
| publishDate | 2024-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Italian Journal of Medicine |
| spelling | doaj.art-0a7ebb5dc896431cbbbaa986b347eae02024-02-01T20:35:04ZengPAGEPress PublicationsItalian Journal of Medicine1877-93441877-93522024-02-0118110.4081/itjm.2024.1693A new stroke mimic prediction scale in a stroke center with a high thrombolysis rateFederico Moroni0Vieri Vannucchi1Costanza Vinci2Simone Bianchi3Alessandra Giuello4Francesco Prosperi Iovi5Michele Lanigra6Angela Konze7Giancarlo Landini8Department of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, FlorenceDepartment of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, FlorenceDepartment of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, FlorenceEmergency Department, Santa Maria Nuova Hospital, FlorenceEmergency Department, Santa Maria Nuova Hospital, FlorenceEmergency Department, Santa Maria Nuova Hospital, FlorenceEmergency Department, Santa Maria Nuova Hospital, FlorenceRadiology Department, Santa Maria Nuova Hospital, FlorenceDepartment of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, Florence Patients reaching the emergency department (ED) with symptoms of acute ischemic stroke (AIS) may be affected by a stroke mimics (SMs). A prompt clinical diagnosis could avoid unnecessary thrombolysis. We evaluated a new and rapid approach, the Santa Maria Nuova-Stroke Mimic (SMN-SM) scale, to improve a prompt clinical diagnosis. 340 consecutive patients admitted to the ED with suspected AIS were evaluated. The final diagnosis was: AIS in 267 (78,5%) and SMs in 73 (21,5%) patients. Multivariate logistical analysis showed that the following features – lack of facial paralysis, dizziness, migraine, seizure disorders, blood pressure <150, cognitive impairment, and female sex – were significantly more abundant in patients with SMs than in AIS. To each of these features we assigned a numerical score and we performed a receiver operating characteristic analysis. When the score of the scale was above 8 (cut-point), we obtained a specificity of 93% and a sensitivity of 56% for a SM diagnosis. Thus, the SMN-SM scale seems a rather useful tool to improve SMs diagnosis. https://italjmed.org/index.php/ijm/article/view/1693Acute ischemic strokestroke mimicdizzinessthrombolysispredictors scale for stroke mimic |
| spellingShingle | Federico Moroni Vieri Vannucchi Costanza Vinci Simone Bianchi Alessandra Giuello Francesco Prosperi Iovi Michele Lanigra Angela Konze Giancarlo Landini A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate Italian Journal of Medicine Acute ischemic stroke stroke mimic dizziness thrombolysis predictors scale for stroke mimic |
| title | A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate |
| title_full | A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate |
| title_fullStr | A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate |
| title_full_unstemmed | A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate |
| title_short | A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate |
| title_sort | new stroke mimic prediction scale in a stroke center with a high thrombolysis rate |
| topic | Acute ischemic stroke stroke mimic dizziness thrombolysis predictors scale for stroke mimic |
| url | https://italjmed.org/index.php/ijm/article/view/1693 |
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