Certainty Of Stroke Symptom Onset Study
Keywords
Abstract
Description
On the day after admission, the patients will be re-interviewed by a stroke neurologist during the rounding in the morning. First the history of symptom onset will be re-taken once more, focusing on the presentation of each neurological symptom. Then the history taken from the emergency department including the onset time will be presented to the patient, and the patient will be asked to choose the certainty for the onset time between 1 and 5.
The symptom onset judged by the neurologist first assessed at the emergency department will be compared to that of the stroke neurologist re-interviewed after admission. If any discrepancy exists, the history of the patient will be re-written by the stroke neurologist and then reviewed by five experienced stroke neurologist. The judgment on stroke onset and the certainty of each stroke neurologist will be compared.
Clinical variables will be obtained from the patient. The informant will be the patient. Demographics including the age and sex will be obtained. Additionally the year of education will be investigated. The situation of stroke onset will be obtained in detail. What the patient was doing immediately before the onset, the place, and the person accompanied with will also be investigated. These will be described on the re-written history which will be reviewed by the five stroke neurologists. The conventional risk factors for stroke and the stroke etiology according to the TOAST classification will be acquired. The initial severity of stroke will also be obtained evaluated by National Institutes of Health Stroke Scale (NIHSS). On the second interview and the re-written history, the symptoms will be investigated in detail. First as an open question, and then targeting the stroke symptoms and the onset of them will be asked. The symptom includes 1) weakness, 2) facial palsy 3) dysarthria 4) ataxia 5) visual field defect 6) sensory change 7) dizziness 8) headache and 9) Other non-specific symptoms. The onset time and the sequence will be investigated by each symptom.
The result will be analyzed in two view points. First the discrepancy rate between clinicians will be first examined, and the clinical variables making difference will be analyzed. finally a protocol for systemized history taking of stroke onset will be used, and the change will be analyzed before and after the release of protocol.
In the second point of veiw, the certainty of patient will be analyzed. The clinical variables will be compared according to the certainty of patient on symptom onset.
Dates
| Last Verified: | 12/31/2018 |
| First Submitted: | 08/10/2013 |
| Estimated Enrollment Submitted: | 08/25/2013 |
| First Posted: | 08/26/2013 |
| Last Update Submitted: | 01/13/2019 |
| Last Update Posted: | 01/15/2019 |
| Actual Study Start Date: | 07/31/2013 |
| Estimated Primary Completion Date: | 05/31/2014 |
| Estimated Study Completion Date: | 07/31/2014 |
Condition or disease
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| Discrepancy in stroke onset Patients with discrepancy in stroke symptom onset based on the diagnosis of the first neurologist who evaluated the patient at emergency room and the next day after admission |
Eligibility Criteria
| Ages Eligible for Study | 20 Years To 20 Years |
| Sexes Eligible for Study | All |
| Sampling method | Probability Sample |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria: - ischemic stroke patients admitted to Acute Stroke Unit at Asan Medical Center - ischemic stroke patients older than 20 years old - symptom onset within 24 hours Exclusion Criteria: - patients who cannot explain the symptom onset due to altered consciousness, aphasia, or cognitive decline |
Outcome
Primary Outcome Measures
1. Discrepancy (difference) in the time onset of stroke symptoms diagnosed by two different neurologists [Onset time will be obtained two times,first at the visit time of emergency department (within 24 hours from onset) and secondly the day after admission (within 48 hours from onset)]
Secondary Outcome Measures
1. Factors influencing the subjective uncertainty of stroke symptom onset by patients [The subjective certainty will be obtained the day after admission (within 48 hours from onset)]
2. Factor influencing the objective discrepancy of stroke symptom onset diagnosed by two different neurologists [The factors will be obtained the day after admission (within 48 hours from symptom onset)]
