Clinical Profile of Stroke Chameleons Receiving Intravenous Thrombolysis: Insights from a Single-Center Experience.

IF 2 Q3 PERIPHERAL VASCULAR DISEASE Cerebrovascular Diseases Extra Pub Date : 2024-11-13 DOI:10.1159/000542502

Alejandro M Brunser, Pablo M Lavados, Paula Muñoz-Venturelli, Verónica V Olavarría, Eloy Mansilla, Gabriel Cavada, Maria Elena Trejo, Pablo E González

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Abstract

Introduction: In emergency rooms (ERs), 5% of patients experiencing an acute ischemic stroke (AIS) receive an alternative diagnosis; these cases are known as stroke chameleons (SC). The percentage of SC treated with intravenous thrombolysis (IVT) and the characteristics have not been well described. We aimed at investigating the variables associated with the probability receiving IVT.

Methods: In this prospective study, we included consecutive patients with SC admitted at the ER of Clínica Alemana between September 2014 and October 2023.

Results: Among 1193 stroke patients; sixty-three (5.2%) corresponded to SC. Ten of these cases (15.8%, 95%CI 8.8-26.8) were treated with IVT, mean door to needle time (DTN) of 85.7 (SD 35) minutes, median of 73.5 (IQR 62-113) minutes. SC who underwent IVT were younger (p=0.01), with higher NIHSS (p=0.05). They presented more frequently with altered level of consciousness in the NIHSS (p=0.01), language abnormities (p=0.001) and dysarthria (p=0.01). In multivariate analysis, none of the variables were significantly associated with IVT. A secondary analysis showed that only time to brain imaging was significantly associated with IVT (OR: 0.99; 95%CI, 0.98-0.99. p=0.01).

Conclusions: almost 1 out of every 7 SC could be treated with IVT but with a prolongued DTN; the chance of being treated is associated with time to brain imaging.

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接受静脉溶栓治疗的中风变色龙的临床概况：单中心经验的启示

导言：在急诊室（ER）中，5% 的急性缺血性卒中（AIS）患者接受了其他诊断，这些病例被称为卒中变色龙（SC）。接受静脉溶栓（IVT）治疗的变色龙比例及其特征尚未得到很好的描述。我们旨在研究与接受静脉溶栓治疗的概率相关的变量：在这项前瞻性研究中，我们纳入了2014年9月至2023年10月期间在Clínica Alemana急诊室住院的连续SC患者：在 1193 名中风患者中，有 63 例（5.2%）符合 SC。其中10例（15.8%，95%CI 8.8-26.8）接受了静脉输液治疗，平均门到针时间（DTN）为85.7分钟（SD 35），中位数为73.5分钟（IQR 62-113）。接受静脉注射的 SC 年龄更小（P=0.01），NIHSS 值更高（P=0.05）。他们更常出现 NIHSS 意识水平改变（p=0.01）、语言异常（p=0.001）和构音障碍（p=0.01）。在多变量分析中，没有一个变量与 IVT 显著相关。二次分析表明，只有脑成像时间与 IVT 显著相关（OR：0.99；95%CI，0.98-0.99。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases Extra PERIPHERAL VASCULAR DISEASE-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.