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Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke.

Publication ,  Journal Article
Bushnell, C; Siddiqi, Z; Morgenlander, JC; Goldstein, LB
Published in: Neurology
March 13, 2001

OBJECTIVE: To investigate the use and appropriateness of specialized coagulation tests in the evaluation of patients with acute ischemic stroke and identify factors that influence test ordering. BACKGROUND: Coagulation abnormalities are a rare but recognized cause of ischemic stroke. METHODS: Patient demographics, stroke risk factors, history of venous thrombosis or miscarriage, family history of stroke, and the results of specialized tests for coagulation disorders were recorded for a consecutive series of ischemic stroke patients over age 18 admitted to an academic medical center over 3 years (n = 674). Factors associated with testing were identified with univariate analyses in a random sample of two-thirds of the patients (n = 450). Multivariate logistic regression modeling was then used to identify variables independently associated with testing and then validated in the remaining patients (n = 224). RESULTS: Of the 31% of patients (n = 208) tested for coagulopathies, 29% (n = 60) were tested when the result was unlikely to influence therapeutic decisions. Historical factors associated with an increased incidence of a coagulopathy, such as history of venous thrombosis or miscarriage, were not commonly documented. The absence of small-artery atherosclerosis (OR 0.36, 95% CI 0.17 to 0.76) and younger age (OR 0.89 per year, 95% CI 0.87 to 0.92) were independently related to the frequency of specialized coagulation testing. CONCLUSIONS: One-third of specialized coagulation tests were ordered when the test results were unlikely to affect therapeutic decisions. Age was the only clinical factor increasing the likelihood of a coagulopathy that appeared to influence ordering of specialized coagulation tests.

Duke Scholars

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

March 13, 2001

Volume

56

Issue

5

Start / End Page

624 / 627

Location

United States

Related Subject Headings

  • Stroke
  • Neurology & Neurosurgery
  • Middle Aged
  • Humans
  • Brain Ischemia
  • Blood Coagulation Tests
  • Aged
  • Adult
  • 3209 Neurosciences
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bushnell, C., Siddiqi, Z., Morgenlander, J. C., & Goldstein, L. B. (2001). Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke. Neurology, 56(5), 624–627. https://doi.org/10.1212/wnl.56.5.624
Bushnell, C., Z. Siddiqi, J. C. Morgenlander, and L. B. Goldstein. “Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke.Neurology 56, no. 5 (March 13, 2001): 624–27. https://doi.org/10.1212/wnl.56.5.624.
Bushnell C, Siddiqi Z, Morgenlander JC, Goldstein LB. Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke. Neurology. 2001 Mar 13;56(5):624–7.
Bushnell, C., et al. “Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke.Neurology, vol. 56, no. 5, Mar. 2001, pp. 624–27. Pubmed, doi:10.1212/wnl.56.5.624.
Bushnell C, Siddiqi Z, Morgenlander JC, Goldstein LB. Use of specialized coagulation testing in the evaluation of patients with acute ischemic stroke. Neurology. 2001 Mar 13;56(5):624–627.

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

March 13, 2001

Volume

56

Issue

5

Start / End Page

624 / 627

Location

United States

Related Subject Headings

  • Stroke
  • Neurology & Neurosurgery
  • Middle Aged
  • Humans
  • Brain Ischemia
  • Blood Coagulation Tests
  • Aged
  • Adult
  • 3209 Neurosciences
  • 3202 Clinical sciences