https://doi.org/10.4081/itjm.2024.1693

A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate

Vol. 18 No. 1 (2024)
Published: 1 February 2024
Acute ischemic stroke, stroke mimic, dizziness, thrombolysis, predictors scale for stroke mimic
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Authors

Federico Moroni
federico.moroni@uslcentro.toscana.it
https://orcid.org/0000-0001-8457-6047
Department of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, Florence, Italy.
Vieri Vannucchi
https://orcid.org/0000-0002-1546-2377
Department of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, Florence, Italy.
Costanza Vinci
https://orcid.org/0009-0005-3541-2798
Department of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, Florence, Italy.
Simone Bianchi
Emergency Department, Santa Maria Nuova Hospital, Florence, Italy.
Alessandra Giuello
Emergency Department, Santa Maria Nuova Hospital, Florence, Italy.
Francesco Prosperi Iovi
Emergency Department, Santa Maria Nuova Hospital, Florence, Italy.
Michele Lanigra
Emergency Department, Santa Maria Nuova Hospital, Florence, Italy.
Angela Konze
https://orcid.org/0000-0002-2960-9755
Radiology Department, Santa Maria Nuova Hospital, Florence, Italy.
Giancarlo Landini
Department of Internal Medicine and Stroke Unit, Santa Maria Nuova Hospital, Florence, Italy.

Patients reaching the emergency department (ED) with symptoms of acute ischemic stroke (AIS) may be affected by a stroke mimics (SMs). A prompt clinical diagnosis could avoid unnecessary thrombolysis. We evaluated a new and rapid approach, the Santa Maria Nuova-Stroke Mimic (SMN-SM) scale, to improve a prompt clinical diagnosis. 340 consecutive patients admitted to the ED with suspected AIS were evaluated. The final diagnosis was: AIS in 267 (78,5%) and SMs in 73 (21,5%) patients. Multivariate logistical analysis showed that the following features – lack of facial paralysis, dizziness, migraine, seizure disorders, blood pressure <150, cognitive impairment, and female sex – were significantly more abundant in patients with SMs than in AIS. To each of these features we assigned a numerical score and we performed a receiver operating characteristic analysis. When the score of the scale was above 8 (cut-point), we obtained a specificity of 93% and a sensitivity of 56% for a SM diagnosis. Thus, the SMN-SM scale seems a rather useful tool to improve SMs diagnosis.

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How to Cite

Moroni, F., Vannucchi, V., Vinci, C., Bianchi, S., Giuello, A., Prosperi Iovi, F., Lanigra, M., Konze, A., & Landini, G. (2024). A new stroke mimic prediction scale in a stroke center with a high thrombolysis rate. Italian Journal of Medicine, 18(1). https://doi.org/10.4081/itjm.2024.1693
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