Abstract
Introduction: The London stroke strategy involves a model of care where all suspected cases of acute stroke are admitted directly to a designated Hyper Acute Stroke Unit (HASU) for the first 72 hours of care. Within the original modelling, the proportion of non-stroke diagnoses (stroke mimics) was estimated at 15%. We report the first six months experience of a single HASU in South West London.
Method: We used local Stroke Improvement National Audit Programme (SINAP) data to analyse the non-stroke admissions to St. George's HASU. Data collection is prospective, 100% complete and commenced on July 19th 2010. Data presented are inclusive to end of February 2011. Length of stay (LoS) is calculated as discharge–admission+1.
Results: There were 1142 HASU admissions, 868 stroke, 274 non-stroke. Non-stroke admission rate ranged 15–30% (mean 24%). Most frequent mimics were migraine 38(13.8%), syncope/pre-syncope 24(8.8%), functional 24(8.8%), delirium 23(8.4%), seizure 22(8.0%), neuropathy 21(7.7%), labyrinthitis/vestibular dysfunction 16(5.8%), Bell's 16(5.8%) and pre-existing stroke symptoms 15(5.5%). 84% of non-stroke (median LoS 2 days) and 50% of stroke patients (median LoS 3 days) were discharged directly home. For patients requiring repatriation to a local hospital, median LoS was 5 days for stroke mimics, and 4 days for stroke.
Conclusion: The stroke mimic rate in our HASU is higher than predicted but the majority were discharged home directly. Where repatriation of stroke mimics was required there were more delays than for repatriated stroke patients. Management of stroke mimics is an important part of HASU care in the London stroke model.
Method: We used local Stroke Improvement National Audit Programme (SINAP) data to analyse the non-stroke admissions to St. George's HASU. Data collection is prospective, 100% complete and commenced on July 19th 2010. Data presented are inclusive to end of February 2011. Length of stay (LoS) is calculated as discharge–admission+1.
Results: There were 1142 HASU admissions, 868 stroke, 274 non-stroke. Non-stroke admission rate ranged 15–30% (mean 24%). Most frequent mimics were migraine 38(13.8%), syncope/pre-syncope 24(8.8%), functional 24(8.8%), delirium 23(8.4%), seizure 22(8.0%), neuropathy 21(7.7%), labyrinthitis/vestibular dysfunction 16(5.8%), Bell's 16(5.8%) and pre-existing stroke symptoms 15(5.5%). 84% of non-stroke (median LoS 2 days) and 50% of stroke patients (median LoS 3 days) were discharged directly home. For patients requiring repatriation to a local hospital, median LoS was 5 days for stroke mimics, and 4 days for stroke.
Conclusion: The stroke mimic rate in our HASU is higher than predicted but the majority were discharged home directly. Where repatriation of stroke mimics was required there were more delays than for repatriated stroke patients. Management of stroke mimics is an important part of HASU care in the London stroke model.
Original language | English |
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Pages (from-to) | 31 |
Number of pages | 1 |
Journal | International Journal of Stroke |
Volume | 6 |
Issue number | Suppl 2 |
Publication status | Published - Dec 2011 |
Externally published | Yes |
Event | UK Stroke Forum Conference 2011 - Glasgow, United Kingdom Duration: 29 Nov 2011 → 1 Dec 2011 https://journals.sagepub.com/doi/abs/10.1111/j.1747-4949.2011.00684.x |