FABS: An Intuitive Tool for Screening of Stroke Mimics in the Emergency Department.
Background and Purpose: A large number of patients with symptoms of acute cerebral ischemia are stroke mimics (SMs). In this study, we sought to develop a scoring system (FABS) for screening and stratifying SM from acute cerebral ischemia and to identify patients who may require magnetic resonance i...
| Publicado en: | Stroke (00392499) Vol. 47; no. 9; pp. 2216 - 2221 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Sep2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=117674688&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 117674688 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00392499 1FT jtl: Stroke (00392499) issn: 00392499 maglogo: N pubinfo: dt: Sep2016 vid: 47 iid: 9 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 117674688 117674688 NLM27491733 10.1161/STROKEAHA.116.013842 NLM27491733 117674688 ppf: 2216 ppct: 5 formats: tig: atl: FABS: An Intuitive Tool for Screening of Stroke Mimics in the Emergency Department. aug: au: Goyal, Nitin Tsivgoulis, Georgios Male, Shailesh Metter, E. Jeffrey Iftikhar, Sulaiman Kerro, Ali Chang, Jason J. Frey, James L. Triantafyllou, Sokratis Papadimitropoulos, Georgios Abedi, Vida Alexandrov, Anne W. Alexandrov, Andrei V. Zand, Ramin affil: Department of Neurology, University of Tennessee Health Science Center, Memphis sug: subj: Stroke Diagnosis Cerebral Ischemia Diagnosis Sensitivity and Specificity Emergency Medical Services Diagnosis, Differential Male Middle Age Magnetic Resonance Imaging Stroke Emergency Service Adult Aged Cerebral Ischemia Female Middle Aged: 45-64 years Adult: 19-44 years Aged: 65+ years Male Female ab: Background and Purpose: A large number of patients with symptoms of acute cerebral ischemia are stroke mimics (SMs). In this study, we sought to develop a scoring system (FABS) for screening and stratifying SM from acute cerebral ischemia and to identify patients who may require magnetic resonance imaging to confirm or refute a diagnosis of stroke in the emergency setting.Methods: We designed a scoring system: FABS (6 variables with 1 point for each variable present): absence of Facial droop, negative history of Atrial fibrillation, Age <50 years, systolic Blood pressure <150 mm Hg at presentation, history of Seizures, and isolated Sensory symptoms without weakness at presentation. We evaluated consecutive patients with symptoms of acute cerebral ischemia and a negative head computed tomography for any acute finding within 4.5 hours after symptom onset in 2 tertiary care stroke centers for validation of FABS.Results: A total of 784 patients (41% SMs) were evaluated. Receiver operating characteristic curve (C statistic, 0.95; 95% confidence interval [CI], 0.93-0.98) indicated that FABS≥3 could identify patients with SM with 90% sensitivity (95% CI, 86%-93%) and 91% specificity (95% CI, 88%-93%). The negative predictive value and positive predictive value were 93% (95% CI, 90%-95%) and 87% (95% CI, 83%-91%), respectively.Conclusions: FABS seems to be reliable in stratifying SM from acute cerebral ischemia cases among patients in whom the head computed tomography was negative for any acute findings. It can help clinicians consider advanced imaging for further diagnosis. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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