Presenter of 1 Presentation
THROMBOLYSED STROKE MIMICS IN THE UNITED KINGDOM: FINDINGS FROM THE NATIONWIDE STROKE REGISTRY
Abstract
Background and Aims
Patients presenting with stroke-like symptoms (stroke mimics) comprise over half the case load seen by stroke teams in the UK. There are limited data to date that investigate factors associated with thrombolysis intervention for this subset of patients.
Methods
Sentinel Stroke National Audit Programme, a national quality improvement registry, collected data on mimics admitted during September 2021. Gender, ethnicity, and diagnoses were compared between those who did and did not receive thrombolysis using Chi2 tests. Age was compared using Mann-Whitney U test. Univariate unadjusted logistic regression was used to determine the likelihood of thrombolysis treatment.
Results
6,295 mimics admitted to 107 hospitals were included in this study; of these, 45 were thrombolysed (0.7%). Median age of thrombolysed mimics was 12 years younger (58 vs 70, p < 0.001) and there was a 2.3% decrease in the odds of receiving thrombolysis each additional year increase in age (OR: 0.977; 95% CI, [0.962 – 0.992]) . No differences were observed between the gender and ethnic make-up of each group. Migraine was the most frequent diagnosis to receive thrombolysis (26.7% of all thrombolysed mimics), followed by unclassified diagnoses (15.6%), functional neurological disorders (FND - 13.3%) and seizure (11.1%). Migraines and FND were significantly more prevalent in the group that received thrombolysis (migraine 26.7% vs 9.5%, p<0.001; FND 13.3% vs 1.2%, p<0.001).
Conclusions
A small but clinically significant proportion of stroke mimics are thrombolysed. They tend to be younger than other mimics, and more likely to have migraine or FND as the final diagnosis.