Impact of subjective symptoms and vital signs on differential diagnosis of stroke

Abstract

Abstract　Background:Most of the prehospital stroke scales are composed of physical assessments. The impact of subjective symptoms and vital signs on stroke diagnosis has been poorly evaluated.
Purpose:The objective of this study was to assess the effectiveness of subjective symptoms and vital signs to identify genuine stroke patients from those suspected of stroke.
Methods:We divided 461 suspected stroke patients into two groups: genuine stroke patients ( n=268 ) and mimics patients ( n=193 ). We focused on the subjective symptoms and vital signs at admission and compared them between the two groups.
Results:The subjective symptoms of hemiparesis and speech abnormality, systolic blood pressure of > 155 mmHg, and irregular cardiac rhythm were more common in the stroke group than in the mimics group. Furthermore, these were all independent factors in multivariate analysis. Body temperature > 38.0 ℃ and hypoxemia were more found in the mimics group than in the stroke group. The facial droop was not a significant factor in univariate analysis.
Conclusion:The subjective symptoms and vital signs were useful predictors for stroke diagnosis.