Journal of Stroke and Cerebrovascular Diseases
Original ArticleIdentification of Nonischemic Stroke Mimics Among 411 Code Strokes at the University of California, San Diego, Stroke Center
Section snippets
Methods
We reviewed records of all Code Stroke activations at our institution during a 31-month span. The patients were identified using the MIDAS (medical information data analysis system) database, which contains data on every stroke admission to our hospital network. We collected the following data on each patient: age, sex, race, and the first 3 International Classification of Diseases, Ninth Revision (ICD-9)–coded discharge diagnoses.5
We analyzed data on the subset of patients for whom a Code
Results
A total of 411 patients presented to the emergency department as Code Stroke from September 1998 to March 2001. Of these patients, 104 (25.3%) were stroke mimics: patients who were discharged without an ICD-9 coding consistent with ischemic cerebrovascular disease. Demographics are listed in Table 1; the differences were not statistically significant. The distribution of diagnoses is shown in Table 2. The most frequent mimic of ischemic stroke was hemorrhage: intracranial hemorrhage (ICH),
Discussion
We found that 25.3% of Code Strokes are activated in patients without acute ischemic cerebrovascular disease, consistent with previous data reporting stroke mimics in 13% and 19%.8, 9 In these studies not all patients were included within 24 hours, hemorrhagic and ischemic stroke were grouped together, and no structured Code Stroke system was used.10, 11 Asimos et al12 reported tPA treatment in 25% of Code Stroke activations and only 8% in stroke mimics.
By focusing on ischemic stroke and
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