Evaluation of pre-hospital stroke diagnosis agreement with emergency diagnosis

Abstract

Many acute diseases can present with symptoms such as stroke, for example hypoglycemia, migraine, seizures and others, and are referred to as stroke mimics (SMs). The purpose of this study was to evaluate the number of patients who are brought to the emergency department by the pre-hospital system with the possibility of stroke and the accuracy of diagnosis and placement in the SAMA code will be evaluated to evaluate the true diagnosis of stroke and its separation

Methods: In this study, which is an observational-cross-sectional-analytical study, patients who were brought to the emergency department of Imam Reza (AS) Hospital by the pre-hospital emergency department during 2017 with a complaint of acute stroke were included in the study, including 150 Became a mission. Patients who left the hospital before the end of the study or whose neurological examination was unreliable due to decreased level of consciousness were excluded from the study. If the patient was from a group where the SAMA code was activated and thrombolytics were prescribed, it was also noted.

Results: In this study, 150 people were included in the study. The median age was 73 years and in the mid-quarters the age range was between 60 and 80 years. Based on the number of missions of pre-hospital emergency personnel, with the possibility of stroke in the patient, in July, November and January shows the highest amount. Most of the patients transferred by the pre-hospital emergency department were in the evening shift. In examining the possible correlation between the data, there is a correlation between thrombolytic administration and diagnosis, but this correlation is weak. There is a significant relationship between the patient's main complaint and the final diagnosis in the emergency room and this relationship is weak. In examining the coefficient of agreement between the patient's history and the final diagnosis given in the emergency, kappa is equal to 0.043.