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ISSN 0028-3851 (Print)

2023, Number 4

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Rev Neurol Neurocir Psiquiat 2023; 51 (4)

Predictors of stroke mimic in Mexico´s first brain stroke care network (ResISSSTE)

Saldaña-Xolalpa J, Baños-Hernández LA, Sicsik-Aragón A, Castellanos-Pedroza E, Núñez-Orozco L

Language: Spanish
References: 32
Page: 168-176
PDF size: 208.77 Kb.


ABSTRACT

Introduction: a large number of patients are admitted to the emergency department with non-vascular neurological alterations that resemble an ischemic stroke (IS), known as Stroke Mimic (SM). The objective of the study was to identify predictive factors and frequent diagnoses of SM in patients of the "ResISSSTE Cerebro" network to help the clinician differentiate these entities and optimize decision-making. Material and methods: observational, analytical, retrospective study of patients with brain code from the "ResISSSTE Cerebro" network in Mexico City from March 2021 to February 2023. We performed a univariate and multivariate analysis using logistic regression with SM vs IS as dependent variables. to identify predictors of MS. Results: of 448 patients analyzed, 299 (67%) IS, 149 (33%) SM. SM was independently associated with age ≤ 65 years (OR 2.725, 95% CI 1.779-4.174, p < 0.001), baseline NIHSS ≤ 6 (OR 15.866, 95% CI 9.748-25.823, p < 0.001), smoking (OR 2.650, 95% CI 1.326-5.296, p = 0.006), ischemic heart disease (OR 2.538, 95% CI 1.264-5.099, p = 0.009), altered consciousness (OR 5.026; 95% CI 2.601-9.712, p < 0.001) , epileptic seizures (OR 4,864, 95% CI 1,239-19,088) and headache (OR 3,893, 95% CI 1,411-10,742). Metabolic encephalopathy 26 (17.4%), functional neurological disorder (16.1%) and epileptic seizures 23 (15.4%) were the most frequent diagnoses of SM. Conclusion: Stroke Mimic predictors in the "ResISSSTE Cerebro" network were ischemic heart disease, smoking, age ≤ 65 years, NIHSS baseline ≤ 6, altered consciousness, headache, and epileptic seizures. Metabolic encephalopathy, functional neurological disorder and epileptic seizures were the most frequent diagnoses.


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