Analysis of Costs and Diagnostic Experience of Stroke Mimics at a Latin American University Hospital

Abstract

Introduction: The incidence of stroke mimic symptoms is around 30%. These symptoms impact healthcare costs, often leading mimic stroke patients to undergo unnecessary clinical tests, imaging, and treatments. Objectives: The main goal of this study is to describe the types of stroke mimic symptoms and estimate healthcare costs in patients with stroke mimics. Secondary objectives include comparing costs based on Telestroke Mimics Stroke and FABS scores and determining the frequency of thrombolysis. Methods: We conducted a retrospective observational study. We reviewed medical records of all patients admitted to Fundación Santa Fe de Bogotá with a final diagnosis of ischemic stroke mimic. We characterized the study population and analyzed the costs of interventions in these patients. Results: A total of 111 patients were included. The average age at mimic presentation was 65 ± 19.4 years, with transient ischemic attack (TIA) being the most common cause of mimics in both sexes, followed by migraine. Tissue plasminogen activator was administered in 0.9% of patients. The direct costs of activating the stroke code averaged US$1,098.72, with a cost of laboratory and imaging at US$773.95. The average cost of total hospitalization was US$2,220.16 per patient. Conclusions: The most frequent cause of stroke mimic was TIA, and thrombolysis was performed in 0.9% of cases. The direct costs incurred by activating the stroke code, diagnostic tests, treatment with intravenous thrombolysis, and hospitalization of patients with stroke mimic are lower compared to other studies.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

No external funding was received

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Fundación Santa Fe de Bogotá University Hospital Commitee of Ethics and Research approval CCEI-12641-2020

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data referred to in the manuscript is available for review/consult

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