Conflict of interest: None declared.
Diagnostic procedures in ischaemic stroke patients with dementia. a population-based study
Article first published online: 11 DEC 2012
© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization
International Journal of Stroke
Volume 10, Issue 1, pages 95–98, January 2015
How to Cite
Béjot, Y., Jacquin, A., Troisgros, O., Rouaud, O., Aboa-Eboulé, C., Hervieu, M., Osseby, G.-V. and Giroud, M. (2015), Diagnostic procedures in ischaemic stroke patients with dementia. a population-based study. International Journal of Stroke, 10: 95–98. doi: 10.1111/j.1747-4949.2012.00948.x
Funding: The Dijon Stroke Registry is supported by the French Institute for Public Health Surveillance (InVS) and Inserm. Y. B. received financial support from the ‘Journées Neurologiques de Langue Française’ and the Regional Council of Burgundy.
- Issue published online: 10 DEC 2014
- Article first published online: 11 DEC 2012
- Manuscript Accepted: 16 JUL 2012
- Manuscript Received: 13 FEB 2012
- French Institute for Public Health Surveillance (InVS) and Inserm
- Journées Neurologiques de Langue Française
- Regional Council of Burgundy
- stroke care
Dementia is a frequent condition in stroke patients.
To investigate the effect of dementia on access to diagnostic procedures in ischaemic stroke patients.
All cases of ischaemic stroke from 2006 to 2010 were identified from the population-based Stroke Registry of Dijon, France. Patients' characteristics were recorded, as was the use of brain computed tomography scans, brain magnetic resonance imaging, electrocardiogram, echocardiography, and Doppler ultrasonography of the cervical arteries. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Logistic regression models were used to evaluate the associations between dementia and the use of the diagnostic procedures.
Of the 907 patients recorded, 104 were excluded because of death and inability to test cognition. Among the remaining 803 patients, 149 (18·5%) had dementia. Almost all of the patients underwent a brain computed tomography scan and an electrocardiogram during their stay. In contrast, the use of both Doppler ultrasonography of the cervical arteries (79·2% versus 90·2%, P < 0·001), echocardiography (32·9% versus 43·6%, P = 0·02), and brain magnetic resonance imaging (21·5% versus 34·4%, P < 0·001) were significantly lower in stroke patients with dementia than in those without. In multivariate logistic regression, dementia was associated with a lower use of both Doppler ultrasonography (odds ratio = 0·49; 95% confidence interval: 0·29–0·81, P = 0·005), echocardiography (odds ratio = 0·57; 95% confidence interval: 0·37–0·89, P = 0·012), brain magnetic resonance imaging (odds ratio = 0·55; 95% confidence interval: 0·34–0·89, P = 0·015), and a comprehensive assessment (odds ratio = 0·62; 95% confidence interval: 0·40–0·96, P = 0·033).
Demented patients were less likely to undergo diagnostic procedures after ischaemic stroke. Further studies are needed to determine whether this lower utilization could account for the reported excess in recurrent events in these patients.