Abstract Details

Title Prominent Rate of Recent Emergency Department Visits among Patients Presenting with Ischemic Stroke: Missed Opportunity for Prevention?

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 216

Objective

Background BACKGROUND: Prominent rates of repeated recent emergency department visits for ischemic stroke cases.

Design/Methods DESIGN/METHODS: Patients were identified using primary International Classification of Diseases (ICD)-9-CM codes from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for 5 consecutive years (2005-2009). NHAMCS is designed to collect data on the utilization and provision of care in emergency departments of hospitals in the United States. We analyzed the rate of ED visits (within 72 hours) of presentation to the ED with acute ischemic stroke. We also identified any differences in the demographic and clinical characteristics of those patients.

Results RESULTS: There were 2,100,785 cases who presented with the diagnosis of ischemic stroke (IS). 61893 (3%) patients were seen in ED within the prior 72 hours before presenting with IS. This latter proportion of patients mostly aged ? 60 years (76.7% versus 75.4%, age groups, df = 7, p<0.0001) and were mostly women (83.3% versus 54.1%, df = 1, p<0.0001). They were less likely to have a history of diabetes mellitus (0% versus 3.2%, p<0.0001) and hypertension (5.9% versus 8.4%, p<0.0001). They had higher rates of brain imaging (96% versus 92.4%, p<0.0001) and MRI scans (21.3% versus 13.2%, p<0.0001) performed in ED at presentation for IS. The admission rate to the hospital was higher (91.7% versus 84.8%, p<0.0001). They presented with higher rates in non-metropolitan statistical areas (24% versus 9.4%, MSA, df = 1, p<0.0001).

Conclusions CONCLUSIONS: In a nationally representative study, a prominent proportion of patients were seen in the ED within the last preceding 72 hours before presenting with ischemic stroke. This observation suggests that emergent preventive measures may be possible by recognizing "at risk" period of ischemic stroke with the ED settings.

Authors/Disclosures
PRESENTER	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Kelly D. Foote, MD	Kelly D. Foote, MD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axio/Neurocrine Biosciences.

��ɫ��

��ɫ��