Key result
Emergency department evaluation missed the diagnosis of acute ischemic stroke in 14.0% of cases; decreased level of consciousness significantly increased the odds of a missed diagnosis (aOR 3.58).
Why the study?
What are the rate, clinical characteristics, and predictors of missed acute ischemic stroke diagnosis in the emergency department?
Observational (n=2,027)
Yes
What are the rate, clinical characteristics, and predictors of missed acute ischemic stroke diagnosis in the emergency department?
One in seven acute ischemic stroke cases are missed in the ED, particularly among younger patients and those with decreased level of consciousness, though the impact on tPA eligibility is small.
No takes yet. Share an insight, caveat, or question.
Clinicians should heighten AIS suspicion in patients with decreased consciousness; this Level 3 cohort study leaves open whether targeted protocols reduce missed diagnoses.
Madsen et al. (2016) conducted an observational in Acute ischemic stroke (n=2,027). Emergency department evaluation was evaluated on Missed diagnosis of acute ischemic stroke in the ED. Emergency department evaluation missed the diagnosis of acute ischemic stroke in 14.0% of cases; decreased level of consciousness significantly increased the odds of a missed diagnosis (aOR 3.58).