A retrospective analysis of patients with a diagnosis of cerebrovascular disease in the emergency department

Abstract

Cerebrovascular diseases (CVD) are clinical pictures, in association with the primary lesions of the brain's vessels, without symptoms or, involving transient or persistent ischemia or hemorrhage in a brain region. Our aim is to assess the data of the patients who were diagnosed as acute CVD in the emergency service (ES), including the arrival and observation times of the patients in the ES, and determining the frequency of the subtypes of acute CVDs retrospectively. The study included 911 patients from September 2001 to January 2004. The data of the study are consist of the demographic characteristics, complaints on admission, risk factors, mental status, vital findings, the arrive and observation times in the ES, routine laboratory examination, and radiologic measures of the cases, obtained from the case notes. The patients were subdivided into three groups as under 45 years old, between 45-65 years old, and over 65 years old. The cases with CVD constituted 4.4% of all emergency service patients. Of the cases, 42% had ischemic stroke (IS), 30.0% had intracerebral hemorrhage (ICH), 27.0% had subarachnoid hemorrhage (SAH), and 1.0% had transient ischemic attack (TIA). Of the patients, 65.1% had a history of hypertension, which was significantly more frequent, compaired to other risk factors. In the patients history, other risk factors included cardiac diseases (21.7% ), stroke (21.7% ), atrial fibrillation (18.2% ), diabetes mellitus (14.9% ), and smoking (13.0% ). There was a family history of stroke in 3.6% of all patients. Atrial fibrilation (37.5% ), which was obtained on admission, was significantly more frequent in IS than other subtypes of CVD. In 70.0% of the patients, hyperglycemia was established. Hyponatremia, which was established in 26.7% of the patients, was more frequent in SAH. Of these patients, 20.7% arrived at ES within the first 3 hours; however 38.5% of the patients arrived at from 3 to 6 hours, and 40,8% of the patients arrived within at the 6 hours. The ratio of the patients with IS (48.7% ) who came from home first three hours was significantly more frequent than the patients who were referred from a hospital (20.7% ). Although most of our results resemble to those in the literature the most important problem is the low ratio of the patients who arrived our hospital within the first three hours. © 2012 OMU.