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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >The 'DeyeCOM Sign': Predictive Value in Acute Stroke Code Evaluations
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The 'DeyeCOM Sign': Predictive Value in Acute Stroke Code Evaluations

机译：“ DeyeCOM标志”：急性卒中代码评估中的预测价值

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Background: Rapid diagnosis in stroke is critical. Computed tomography is often performed initially, even before a neurologic examination. Gaze deviation has been correlated with stroke diagnosis in some cohorts. Conjugate gaze deviation on stroke code imaging, the "DeyeCOM sign," may have emergency stroke care implications. Methods: We evaluated stroke code imaging from the University of California, San Diego database (2007-2013) for "DeyeCOM sign" diagnostic and predictive utility. Patients were grouped as DeyeCOM+ if conjugate gaze deviation was noted. The differences were assessed using the Fisher exact test for categorical and the Wilcoxon rank-sum test for continuous variables. Results: We evaluated 342 patients; 106 (31%) were DeyeCOM+. Mean age was 63. The most common diagnoses in the DeyeCOM+ group were ischemic stroke (50.94%), transient ischemic attack (8.49%), other (8.49%), somatization (6.6%), and hemorrhage (5.66%). The National Institutes of Health Stroke Scale was greater in stroke patients than that in nonstroke (8.2 versus 3.8; P < .0001), and in DeyeCOM+ compared with DeyeCOM- (6.8 versus 5.6; P = .03). DeyeCOM+ patients were more likely to have a +gaze score (26.4% versus 9.8%; P < .0001), and +gaze patients were more likely to have final stroke diagnosis (26.0% versus 3.6%; P < .0001). There was no overall difference between groups in final stroke diagnosis; however, patients with deviation of 15 degrees or more were more likely to have final diagnosis stroke (63.9% versus 47.9%; P = .03). Conclusions: DeyeCOM+ patients scored higher and were more likely to have +gaze on the stroke scale, and deviation of 15 degrees or more was correlated with final diagnosis stroke. In current environments, there is pressure to complete stroke evaluations rapidly. Reliable imaging information obtained early (such as gaze deviation on scan correlating with scale score and final stroke diagnosis) could augment decision making even with negative imaging.
机译：背景：中风的快速诊断至关重要。计算机断层扫描通常是在开始时进行的，甚至在进行神经系统检查之前也是如此。在某些队列中，凝视偏差与中风诊断相关。中风代码成像中的共轭视线偏差“ DeyeCOM标志”可能会涉及紧急中风护理。方法：我们评估了加州大学圣地亚哥分校数据库（2007-2013）的笔划代码成像对“ DeyeCOM征兆”的诊断和预测作用。如果发现共轭注视偏差，将患者分组为DeyeCOM +。使用Fisher精确检验对分类进行评估，并使用Wilcoxon秩和检验对连续变量进行评估。结果：我们评估了342例患者。 DeyeCOM +为106（31％）。平均年龄为63岁。DeyeCOM +组中最常见的诊断是缺血性中风（50.94％），短暂性脑缺血发作（8.49％），其他（8.49％），躯体化（6.6％）和出血（5.66％）。美国国立卫生研究院卒中量表在卒中患者中比非卒中患者大（8.2比3.8; P <.0001），与DeyeCOM-相比，DeyeCOM +与DeyeCOM-相比更大（6.8比5.6; P = .03）。 DeyeCOM +患者更有可能获得+凝视得分（26.4％对9.8％; P <.0001），而+凝视患者更可能具有最终卒中诊断（26.0％对3.6％; P <.0001）。最终卒中的诊断在各组之间没有总体差异。然而，偏差大于或等于15度的患者更有可能最终诊断为中风（63.9％对47.9％; P = .03）。结论：DeyeCOM +患者得分更高，并且在中风量表上有更多的凝视感，并且15度或以上的偏差与最终诊断中风相关。在当前环境中，存在着迅速完成冲程评估的压力。尽早获得可靠的成像信息（例如与比例尺得分和最终卒中诊断相关的扫描凝视偏差）即使是负成像也可以增强决策能力。

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