Hemodynamic characteristics of suspected stroke in the emergency department.
Miller JB, Nowak RM, Reed BP, DiSomma S, Nanayakkara P, Moyer M, Millis S, Kinni H, and Levy P. Hemodynamic characteristics of suspected stroke in the emergency department. Am J Emerg Med 2017.
The American journal of emergency medicine
BACKGROUND: Systemic hemodynamic characteristics of patients with suspected acute ischemic stroke are poorly described. The objective of this study was to identify baseline hemodynamic characteristics of emergency department (ED) patients with suspected acute stroke.
METHODS: This was a planned analysis of the stroke cohort from a multicenter registry of hemodynamic profiling of ED patients. The registry prospectively collected non-invasive hemodynamic measurements of patients with suspicion for acute stroke within 12h of symptom onset. K-means cluster analysis identified hemodynamic phenotypes of all suspected stroke patients, and we performed univariate hemodynamic comparisons based on final diagnoses.
RESULTS: There were 72 patients with suspected acute stroke, of whom 38 (53%) had a final diagnosis of ischemic stroke, 10 (14%) had hemorrhagic stroke, and 24 (33%) had transient ischemic attack (TIA). Analysis defined three phenotypic clusters based on low or normal cardiac index (CI) and normal or high systemic vascular resistance index (SVRI). Patients with TIA had lower mean CI (2.3L/min/m2) compared to hemorrhagic or ischemic stroke patients (p<0.01).
CONCLUSIONS: The study demonstrates the feasibility of defining hemodynamic phenotypes of ED patients with suspected stroke.
Medical Subject Headings
Aged; Cluster Analysis; Emergency Service, Hospital; Female; Heart Rate; Hemodynamics; Humans; Ischemic Attack, Transient; Male; Middle Aged; Monitoring, Physiologic; Phenotype; Prospective Studies; Registries; Stroke; Vascular Resistance