Abstract P175: Dizziness-Related Symptoms are Associated With Delayed Diagnostic Imaging in Patients With Intracerebral Hemorrhage

Autor:	Tracy E. Madsen, Karen L. Furie, Michael E. Reznik, Carlin Chuck, Linda C. Wendell, Ali Mahta, Scott Moody, Bradford B Thompson, Savannah R Doelfel, Christoph Stretz, Roshini Kalagara, Helen Zhou
Rok vydání:	2021
Předmět:	Advanced and Specialized Nursing Intracerebral hemorrhage medicine.medical_specialty business.industry Emergency medicine Medical imaging medicine In patient Neurology (clinical) Emergency department Cardiology and Cardiovascular Medicine medicine.disease business
Zdroj:	Stroke. 52
ISSN:	1524-4628 0039-2499
DOI:	10.1161/str.52.suppl_1.p175
Popis:	Background: Acute dizziness can present diagnostic challenges for emergency department (ED) clinicians because of the potential for an underlying cerebrovascular cause. Although various strategies may aid in diagnosing cases caused by stroke, it is unclear whether dizziness due to intracerebral hemorrhage (ICH) is associated with delays in diagnostic imaging. Methods: We performed a single center cohort study on consecutive ICH patients admitted over 2 years. We retrospectively abstracted initial reported symptoms and aggregated patients with dizziness, vertigo, lightheadedness, or nausea under the category of dizziness-related symptoms. After excluding patients with ED intubation due to potential procedural delays, we calculated time from initial ED arrival to first computed tomography (CT) scan. Using linear regression, we determined associations between dizziness-related symptoms and ED-to-CT time after adjusting for demographics and time from symptom onset, with additional analyses considering the presence of typical stroke symptoms and cerebellar ICH. Results: Of 427 patients, 110 (26%) presented with dizziness-related symptoms and 36 (8%) had cerebellar ICH. In univariate analyses, patients with dizziness-related symptoms had longer ED-to-CT times than other patients (median [IQR] 51 [21-144] vs. 32 [14-92] min, p=0.007), as did those with cerebellar ICH (71 [27-182] min). In our primary adjusted model, dizziness-related symptoms were associated with longer ED-to-CT times (+26 min [95% CI 6-46]). This imaging delay was further compounded in a subgroup analysis of patients without typical stroke symptoms (+45 min [95% CI 7-84], and in a separate model considering patients with cerebellar ICH (+48 min [95% CI 17-80]). Conclusions: Dizziness-related symptoms are associated with delayed diagnostic imaging in patients with ICH, which suggests the need for increased early awareness and urgency in these cases.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::c07636d03a05cbd7dee9985a5bbf7f70 https://doi.org/10.1161/str.52.suppl_1.p175 Zobrazit plný text záznamu