Community hospital-based stroke programs in North Carolina, Oregon, and New York: IV. Stroke diagnosis and its relation to demographics, risk factors, and clinical status after stroke

Bruce M Coull, Joni K. Brockschmidt, George Howard, Caroline Becker, Frank M. Yatsu, James F. Toole, Kenneth R. McLeroy, John Feibel

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

The use of diagnostic tests, the accuracy of stroke type diagnosis, and their relationship to outcome are important from the standpoint of patient management and health care costs. To address this issue, we examined the differences between stroke types in terms of demographics, risk factors, diagnostic tests, and clinical outcome in the 4,129 patients who comprise the Community Hospital-Based Stroke Program. Previous transient ischemic attacks were equally frequent among patients with embolic and those with thrombotic stroke. For all stroke types, previous stroke was as frequent as previous transient ischemic attacks. Hypertension and cardiac disease were the most common risk factors, but 10% of all stroke patients had no recognized risk factors. Intracerebral hemorrhage was most often associated with death (45%). There was a strong direct relation between in-hospital mortality and a decreased level of consciousness at admission. Overall, 30% of patients did not receive a specific stroke type diagnosis; these patients were elderly, usually nonwhite, and often had an altered level of consciousness at admission but had a risk factor profile similar to that of patients who received a specific stroke type diagnosis. In summary, our findings suggest the continued need for physician education about and refinement of stroke type diagnosis.

Original languageEnglish (US)
Pages (from-to)867-873
Number of pages7
JournalStroke
Volume21
Issue number6
StatePublished - Jun 1990
Externally publishedYes

Fingerprint

Community Hospital
Stroke
Demography
Transient Ischemic Attack
Routine Diagnostic Tests
Consciousness Disorders
Cerebral Hemorrhage
Hospital Mortality
Consciousness
Health Care Costs
Heart Diseases
Patient Care
Hypertension
Physicians
Education

Keywords

  • Cerebrovascular disorders
  • Diagnosis
  • Epidemiology
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Community hospital-based stroke programs in North Carolina, Oregon, and New York : IV. Stroke diagnosis and its relation to demographics, risk factors, and clinical status after stroke. / Coull, Bruce M; Brockschmidt, Joni K.; Howard, George; Becker, Caroline; Yatsu, Frank M.; Toole, James F.; McLeroy, Kenneth R.; Feibel, John.

In: Stroke, Vol. 21, No. 6, 06.1990, p. 867-873.

Research output: Contribution to journalArticle

Coull, Bruce M ; Brockschmidt, Joni K. ; Howard, George ; Becker, Caroline ; Yatsu, Frank M. ; Toole, James F. ; McLeroy, Kenneth R. ; Feibel, John. / Community hospital-based stroke programs in North Carolina, Oregon, and New York : IV. Stroke diagnosis and its relation to demographics, risk factors, and clinical status after stroke. In: Stroke. 1990 ; Vol. 21, No. 6. pp. 867-873.
@article{943fe3ed73f74d6e95c662caae756e85,
title = "Community hospital-based stroke programs in North Carolina, Oregon, and New York: IV. Stroke diagnosis and its relation to demographics, risk factors, and clinical status after stroke",
abstract = "The use of diagnostic tests, the accuracy of stroke type diagnosis, and their relationship to outcome are important from the standpoint of patient management and health care costs. To address this issue, we examined the differences between stroke types in terms of demographics, risk factors, diagnostic tests, and clinical outcome in the 4,129 patients who comprise the Community Hospital-Based Stroke Program. Previous transient ischemic attacks were equally frequent among patients with embolic and those with thrombotic stroke. For all stroke types, previous stroke was as frequent as previous transient ischemic attacks. Hypertension and cardiac disease were the most common risk factors, but 10{\%} of all stroke patients had no recognized risk factors. Intracerebral hemorrhage was most often associated with death (45{\%}). There was a strong direct relation between in-hospital mortality and a decreased level of consciousness at admission. Overall, 30{\%} of patients did not receive a specific stroke type diagnosis; these patients were elderly, usually nonwhite, and often had an altered level of consciousness at admission but had a risk factor profile similar to that of patients who received a specific stroke type diagnosis. In summary, our findings suggest the continued need for physician education about and refinement of stroke type diagnosis.",
keywords = "Cerebrovascular disorders, Diagnosis, Epidemiology, Risk factors",
author = "Coull, {Bruce M} and Brockschmidt, {Joni K.} and George Howard and Caroline Becker and Yatsu, {Frank M.} and Toole, {James F.} and McLeroy, {Kenneth R.} and John Feibel",
year = "1990",
month = "6",
language = "English (US)",
volume = "21",
pages = "867--873",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Community hospital-based stroke programs in North Carolina, Oregon, and New York

T2 - IV. Stroke diagnosis and its relation to demographics, risk factors, and clinical status after stroke

AU - Coull, Bruce M

AU - Brockschmidt, Joni K.

AU - Howard, George

AU - Becker, Caroline

AU - Yatsu, Frank M.

AU - Toole, James F.

AU - McLeroy, Kenneth R.

AU - Feibel, John

PY - 1990/6

Y1 - 1990/6

N2 - The use of diagnostic tests, the accuracy of stroke type diagnosis, and their relationship to outcome are important from the standpoint of patient management and health care costs. To address this issue, we examined the differences between stroke types in terms of demographics, risk factors, diagnostic tests, and clinical outcome in the 4,129 patients who comprise the Community Hospital-Based Stroke Program. Previous transient ischemic attacks were equally frequent among patients with embolic and those with thrombotic stroke. For all stroke types, previous stroke was as frequent as previous transient ischemic attacks. Hypertension and cardiac disease were the most common risk factors, but 10% of all stroke patients had no recognized risk factors. Intracerebral hemorrhage was most often associated with death (45%). There was a strong direct relation between in-hospital mortality and a decreased level of consciousness at admission. Overall, 30% of patients did not receive a specific stroke type diagnosis; these patients were elderly, usually nonwhite, and often had an altered level of consciousness at admission but had a risk factor profile similar to that of patients who received a specific stroke type diagnosis. In summary, our findings suggest the continued need for physician education about and refinement of stroke type diagnosis.

AB - The use of diagnostic tests, the accuracy of stroke type diagnosis, and their relationship to outcome are important from the standpoint of patient management and health care costs. To address this issue, we examined the differences between stroke types in terms of demographics, risk factors, diagnostic tests, and clinical outcome in the 4,129 patients who comprise the Community Hospital-Based Stroke Program. Previous transient ischemic attacks were equally frequent among patients with embolic and those with thrombotic stroke. For all stroke types, previous stroke was as frequent as previous transient ischemic attacks. Hypertension and cardiac disease were the most common risk factors, but 10% of all stroke patients had no recognized risk factors. Intracerebral hemorrhage was most often associated with death (45%). There was a strong direct relation between in-hospital mortality and a decreased level of consciousness at admission. Overall, 30% of patients did not receive a specific stroke type diagnosis; these patients were elderly, usually nonwhite, and often had an altered level of consciousness at admission but had a risk factor profile similar to that of patients who received a specific stroke type diagnosis. In summary, our findings suggest the continued need for physician education about and refinement of stroke type diagnosis.

KW - Cerebrovascular disorders

KW - Diagnosis

KW - Epidemiology

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=0025354011&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025354011&partnerID=8YFLogxK

M3 - Article

C2 - 2349589

AN - SCOPUS:0025354011

VL - 21

SP - 867

EP - 873

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 6

ER -