Yield of Echocardiography in the Evaluation of Cerebral Ischemic Events: A Single Center Cohort Study.
Aged
Aged, 80 and over
Brain Ischemia
/ diagnostic imaging
Chile
Clinical Decision-Making
Echocardiography, Transesophageal
Female
Heart Diseases
/ complications
Humans
Ischemic Attack, Transient
/ diagnostic imaging
Male
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Factors
Stroke
/ diagnostic imaging
Acute stroke
diagnosis
echocardiography
ischemic stroke
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
15
05
2018
revised:
11
10
2018
accepted:
29
10
2018
pubmed:
27
11
2018
medline:
15
3
2019
entrez:
27
11
2018
Statut:
ppublish
Résumé
Echocardiography (ECO) is frequently used as a screening test in patients with acute ischemic brain disease. We aimed to evaluate the additional information and therapeutic impact resulting from ECO in these patients. We conducted a prospective study performing ECO on consecutive patients with ischemic stroke or transient ischemic attacks, admitted to our centre between February 2013 and May 2017. A total of 696 patients were included (female, 57.3%; mean age, 70 ± 15.3 years). Seven hundred thirty two echocardiographic examinations were performed (696 transthoracic and 36 transesophageal). Echocardiography yielded findings judged of clinical importance in 142 patients (20.4%, 95% CI 17.5-23.5). The most frequent of these were left atrial volume enlargement or a normal evaluation. Echocardiography findings resulted in changes in the management of 76 patients (10.7% 95% CI 8.8-13.4); initiation of anticoagulation therapy, administration of IV antibiotic therapy, cardiac surgeries, or other pharmacological therapies occurring in 42 cases (6%). The presence of coronary heart disease (OR: 2.64 95% CI 1.34-5.25), atrial fibrillation (OR: 0.24; 95% CI, 0.2-0.69), and admission NIHSS (OR: 1.04; 95% CI, 1.01-1.09), were the variables associated with changes in management. In unselected patients with acute ischemic stroke ECO had a low yield of additional information, and it changed management in a small percentage of patients.
Sections du résumé
BACKGROUND
BACKGROUND
Echocardiography (ECO) is frequently used as a screening test in patients with acute ischemic brain disease. We aimed to evaluate the additional information and therapeutic impact resulting from ECO in these patients.
METHODS
METHODS
We conducted a prospective study performing ECO on consecutive patients with ischemic stroke or transient ischemic attacks, admitted to our centre between February 2013 and May 2017.
RESULTS
RESULTS
A total of 696 patients were included (female, 57.3%; mean age, 70 ± 15.3 years). Seven hundred thirty two echocardiographic examinations were performed (696 transthoracic and 36 transesophageal). Echocardiography yielded findings judged of clinical importance in 142 patients (20.4%, 95% CI 17.5-23.5). The most frequent of these were left atrial volume enlargement or a normal evaluation. Echocardiography findings resulted in changes in the management of 76 patients (10.7% 95% CI 8.8-13.4); initiation of anticoagulation therapy, administration of IV antibiotic therapy, cardiac surgeries, or other pharmacological therapies occurring in 42 cases (6%). The presence of coronary heart disease (OR: 2.64 95% CI 1.34-5.25), atrial fibrillation (OR: 0.24; 95% CI, 0.2-0.69), and admission NIHSS (OR: 1.04; 95% CI, 1.01-1.09), were the variables associated with changes in management.
CONCLUSIONS
CONCLUSIONS
In unselected patients with acute ischemic stroke ECO had a low yield of additional information, and it changed management in a small percentage of patients.
Identifiants
pubmed: 30473460
pii: S1052-3057(18)30622-0
doi: 10.1016/j.jstrokecerebrovasdis.2018.10.042
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
562-568Informations de copyright
Copyright © 2018. Published by Elsevier Inc.