Hemodynamic characteristics of suspected stroke in the emergency department |
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| Authors: | Joseph B Miller Richard M Nowak Brian P Reed Salvatore DiSomma Prabath Nanayakkara Michele Moyer Scott Millis Harish Kinni Phillip Levy |
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| Institution: | 1. Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, USA;2. Department of Biostatistics, Wayne State University, Detroit, MI, USA;3. Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza, Rome, Italy;4. Section of Acute Medicine, Department of Internal Medicine, VU Medical Center, Amsterdam, Netherlands;5. Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, USA;6. Department of Biostatistics, Wayne State University, Detroit, MI, USA;7. Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, USA;8. Departments of Emergency Medicine and Physiology and Cardiovascular Research Institute, Wayne State University, Detroit, MI, USA |
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| Abstract: | BackgroundSystemic 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.MethodsThis 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 12 h 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.ResultsThere 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 (2.3 L/min/m2) compared to hemorrhagic or ischemic stroke patients (p < 0.01).ConclusionsThe study demonstrates the feasibility of defining hemodynamic phenotypes of ED patients with suspected stroke. |
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| Keywords: | Stroke Hemodynamic Cardiac output Transient ischemic attack Intracerebral hemorrhage Emergency department |
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