Yield of Echocardiography in the Evaluation of Cerebral Ischemic Events: A Single Center Cohort Study
| Autor: | Pablo M. Lavados, Eloy Mansilla, Martin Larico, Verónica V. Olavarría, Alexis Rojo, Juan Almeida, Gabriel Cavada, Alejandro M. Brunser, Paula Muñoz, Rodrigo Ibañez-Arenas |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Heart Diseases Clinical Decision-Making Disease Single Center Brain Ischemia 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Left atrial Internal medicine medicine Humans In patient Prospective Studies Chile Prospective cohort study Aged Aged 80 and over business.industry Rehabilitation Atrial fibrillation Prognosis medicine.disease Stroke Ischemic Attack Transient Ischemic stroke Cardiology Female Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 28:562-568 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2018.10.042 |
| Popis: | Background: Echocardiography (ECO) is frequently used as a screening test in patients with acute ischemic brain disease. We aimed to evaluate the additional information and therapeutic impact resulting from ECO in these patients. Methods: We conducted a prospective study performing ECO on consecutive patients with ischemic stroke or transient ischemic attacks, admitted to our centre between February 2013 and May 2017. Results: A total of 696 patients were included (female, 57.3%; mean age, 70 ± 15.3 years). Seven hundred thirty two echocardiographic examinations were performed (696 transthoracic and 36 transesophageal). Echocardiography yielded findings judged of clinical importance in 142 patients (20.4%, 95% CI 17.5-23.5). The most frequent of these were left atrial volume enlargement or a normal evaluation. Echocardiography findings resulted in changes in the management of 76 patients (10.7% 95% CI 8.8-13.4); initiation of anticoagulation therapy, administration of IV antibiotic therapy, cardiac surgeries, or other pharmacological therapies occurring in 42 cases (6%). The presence of coronary heart disease (OR: 2.64 95% CI 1.34-5.25), atrial fibrillation (OR: 0.24; 95% CI, 0.2-0.69), and admission NIHSS (OR: 1.04; 95% CI, 1.01-1.09), were the variables associated with changes in management. Conclusions: In unselected patients with acute ischemic stroke ECO had a low yield of additional information, and it changed management in a small percentage of patients. |
| Databáze: | OpenAIRE |
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