“Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis
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 p...
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| Language: | English |
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Wiley
2019-01-01
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| Series: | Neurology Research International |
| Online Access: | http://dx.doi.org/10.1155/2019/2105670 |
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| author | Patrick M. Chen Dawn M. Meyer Robert Claycomb Kunal Agrawal Brett C. Meyer |
| author_facet | Patrick M. Chen Dawn M. Meyer Robert Claycomb Kunal Agrawal Brett C. Meyer |
| author_sort | Patrick M. Chen |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-f6a2c298763948c18b45c1edf826738e |
| institution | Kabale University |
| issn | 2090-1852 2090-1860 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neurology Research International |
| spelling | doaj-art-f6a2c298763948c18b45c1edf826738e2025-02-03T01:31:10ZengWileyNeurology Research International2090-18522090-18602019-01-01201910.1155/2019/21056702105670“Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final DiagnosisPatrick M. Chen0Dawn M. Meyer1Robert Claycomb2Kunal Agrawal3Brett C. Meyer4Department of Neurosciences, Stroke Center, University of California San Diego, San Diego, CA, USADepartment of Neurosciences, Stroke Center, University of California San Diego, San Diego, CA, USADesert Regional Medical Center, Palm Springs, CA, USADepartment of Neurosciences, Stroke Center, University of California San Diego, San Diego, CA, USADepartment of Neurosciences, Stroke Center, University of California San Diego, San Diego, CA, USAStroke 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.http://dx.doi.org/10.1155/2019/2105670 |
| spellingShingle | Patrick M. Chen Dawn M. Meyer Robert Claycomb Kunal Agrawal Brett C. Meyer “Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis Neurology Research International |
| title | “Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis |
| title_full | “Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis |
| title_fullStr | “Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis |
| title_full_unstemmed | “Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis |
| title_short | “Encephalopathy Only Stroke Codes” (EoSC) Rarely Result in Stroke as Final Diagnosis |
| title_sort | encephalopathy only stroke codes eosc rarely result in stroke as final diagnosis |
| url | http://dx.doi.org/10.1155/2019/2105670 |
| work_keys_str_mv | AT patrickmchen encephalopathyonlystrokecodeseoscrarelyresultinstrokeasfinaldiagnosis AT dawnmmeyer encephalopathyonlystrokecodeseoscrarelyresultinstrokeasfinaldiagnosis AT robertclaycomb encephalopathyonlystrokecodeseoscrarelyresultinstrokeasfinaldiagnosis AT kunalagrawal encephalopathyonlystrokecodeseoscrarelyresultinstrokeasfinaldiagnosis AT brettcmeyer encephalopathyonlystrokecodeseoscrarelyresultinstrokeasfinaldiagnosis |