PT  - JOURNAL ARTICLE
AU  - Ang Dawson
AU  - Geoffrey C Cloud
AU  - Anthony C Pereira
AU  - Barry J Moynihan
TI  - Stroke mimic diagnoses presenting to a hyperacute stroke unit
AID  - 10.7861/clinmedicine.16-5-423
DP  - 2016 Oct 01
TA  - Clinical Medicine
PG  - 423--426
VI  - 16
IP  - 5
4099  - http://www.rcpjournals.org/content/16/5/423.short
4100  - http://www.rcpjournals.org/content/16/5/423.full
SO  - Clin Med2016 Oct 01; 16
AB  - Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George’s Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered.