Stroke Rounds: Early Signs of Stroke Missed in Many Cases
Written by Editor   
Tuesday, April 08, 2014 12:00 AM

Many strokes may be missed in emergency departments (EDs) in the days before the problems become obvious, a retrospective study suggested.  Of 187,188 admissions for stroke, 12.7% were associated with an ED visit in the preceding 30-day period that ended with any non-cerebrovascular diagnosis, indicating a potentially missed stroke.  About one in every 10 of those potential misses were ED visits that ended with a discharge diagnosis of headache or dizziness, and those were considered probable missed strokes.

Several types of patients, including those younger than 45, women, and those from minority groups, had an increased likelihood of experiencing a missed stroke.  "This study provides some immediate suggestions to ED physicians who are evaluating patients with these symptoms -- be more attuned to the possibility of stroke in younger, female, and non-white patients."

"Clinicians should leverage well-studied bedside methods to identify dizziness and headache patients at high risk for stroke."  Stroke is commonly missed diagnosis, with one study showing that "preventable deaths from stroke are attributed to diagnostic error over 30 times more often than deaths from myocardial infarction," according to the authors.