&lt;p&gt;The positive predictive value of spontaneous subarachnoid hemorrhage diagnoses in the Danish National Patient Register&lt;/p&gt;

Sonne, Asger; Andersen, J.; Rasmussen, Lars S.

doi:10.2147/clep.s197251

Cited by 12 publications

(11 citation statements)

References 25 publications

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“…We found that the prevalence or incidences of Alzheimer's disease, Parkinson's disease, narcolepsy, and intracerebral hemorrhage were representative of the Danish and other Western populations ( Supplementary Table 7 ) ( 63 ). However, the prevalence of ischemic stroke, subarachnoid hemorrhage, and GBS were higher than previous reports from Denmark ( 64 – 66 ). While these results may be surprising, they are in line with a recent Danish study of 23,688 individuals that showed an increase in ischemic stroke in the pandemic period from March 13, 2020 – February 28, 2021, ( 67 ) and another showing increasing rates of GBS from 2019 to 2020 ( 68 ).…”

Section: Discussioncontrasting

confidence: 78%

Frequency of Neurological Diseases After COVID-19, Influenza A/B and Bacterial Pneumonia

et al. 2022

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IntroductionCOVID-19 might affect the incidence of specific neurological diseases, but it is unknown if this differs from the risk following other infections. Here, we characterized the frequency of neurodegenerative, cerebrovascular, and immune-mediated neurological diseases after COVID-19 compared to individuals without COVID-19 and those with other respiratory tract infections.MethodsThis population-based cohort study utilized electronic health records covering ~50% of Denmark's population (n = 2,972,192). Between 02/2020 and 11/2021, we included individuals tested for COVID-19 or diagnosed with community-acquired bacterial pneumonia in hospital-based facilities. Additionally, we included individuals tested for influenza in the corresponding pre-pandemic period between 02/ 2018 and 11/2019. We stratified cohorts for in- and outpatient status, age, sex, and comorbidities.ResultsIn total, 919,731 individuals were tested for COVID-19, of whom 43,375 tested positive (35,362 outpatients, 8,013 inpatients). Compared to COVID-negative outpatients, COVID-19 positive outpatients had an increased RR of Alzheimer's disease (RR = 3.5; 95%CI: 2.2–5.5) and Parkinson's disease (RR = 2.6; 95%CI: 1.7–4.0), ischemic stroke (RR = 2.7; 95%CI: 2.3–3.2) and intracerebral hemorrhage (RR = 4.8; 95%CI: 1.8–12.9). However, when comparing to other respiratory tract infections, only the RR for ischemic stroke was increased among inpatients with COVID-19 when comparing to inpatients with influenza (RR = 1.7; 95%CI: 1.2–2.4) and only for those >80 years of age when comparing to inpatients with bacterial pneumonia (RR = 2.7; 95%CI: 1.2–6.2). Frequencies of multiple sclerosis, myasthenia gravis, Guillain-Barré syndrome and narcolepsy did not differ after COVID-19, influenza and bacterial pneumonia.ConclusionThe risk of neurodegenerative and cerebrovascular, but not neuroimmune, disorders was increased among COVID-19 positive outpatients compared to COVID-negative outpatients. However, except for ischemic stroke, most neurological disorders were not more frequent after COVID-19 than after other respiratory infections.

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Section: Discussioncontrasting

confidence: 78%

Frequency of Neurological Diseases After COVID-19, Influenza A/B and Bacterial Pneumonia

et al. 2022

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“…21,22 As the Stroke Registry did not include patients with SAH until 2017, we identified these patients from the Danish National Patient Registry, which covers all Danish hospitals. Because of the moderate positive predictive value of the SAH diagnosis (61%-67%), 23 we focused primarily on ischemic stroke and ICH.…”

Section: Study Populationmentioning

confidence: 99%

Risks of Stroke Recurrence and Mortality After First and Recurrent Strokes in Denmark

et al. 2022

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Background and Objectives:To examine risks of stroke recurrence and mortality after first and recurrent stroke.Methods:Using Danish nationwide health registries, we included patients (age ≥18 years) with first-time ischemic stroke (N = 105,397) or intracerebral hemorrhage (N = 13,350) during 2004–2018. Accounting for the competing risk of death, absolute risks of stroke recurrence were computed separately for each stroke subtype and within strata of age groups, sex, stroke severity, body mass index, smoking, alcohol, the Essen stroke risk score, and atrial fibrillation. Mortality risks were computed after first and recurrent stroke.Results:After adjusting for competing risks, the overall 1-year and 10-year risks of recurrence were 4% and 13% following first-time ischemic stroke and 3% and 12% following first-time intracerebral hemorrhage. For ischemic stroke, the risk of recurrence increased with age, was higher for men and following mild than more severe stroke. The most marked differences were across Essen risk scores, for which recurrence risks increased with increasing scores. For intracerebral hemorrhage, risks were similar for both sexes and did not increase with Essen risk score. For ischemic stroke, the 1-year and 10-year risks of all-cause mortality were 17% and 56% after a first-time stroke and 25% and 70% after a recurrent stroke; corresponding estimates for intracerebral hemorrhage were 37% and 70% after a first-time event and 31% and 75% after a recurrent event.Conclusion:The risk of stroke recurrence was substantial following both subtypes, but risks differed markedly among patient subgroups. The risk of mortality was higher after a recurrent than first-time stroke.

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“…The uncharacteristic and diverse symptoms may result in initial under-triage and subsequent treatment delays even when patients are seen face-to-face by medical professionals in emergency departments [ 6 ]. In addition, SAH is a rare event with an incidence rate of 5.5 per 100,000 person-years [ 7 ] and consequently EMDs will infrequently encounter these patients. Our knowledge of SAH symptoms is predominantly based on retrospective studies [ 8 , 9 ] and patients’ presentations in emergency department settings [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Symptoms presented during emergency telephone calls for patients with spontaneous subarachnoid haemorrhage

Sonne

Egholm

Elgaard

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background A spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivity of these and their association (odds ratio, OR) with SAH. Methods This was a nested case–control study based on all telephone calls to the medical dispatch center of Copenhagen Emergency Medical Services in a 4-year time period. Patients with SAH were identified in the Danish National Patient Register; diagnoses were verified by medical record review and their emergency telephone call audio files were extracted. Audio files were replayed, and symptoms extracted in a standardized manner. Audio files of a control group were replayed and assessed as well. Results We included 224 SAH patients and 609 controls. Cardiac arrest and persisting unconsciousness were reported in 5.8% and 14.7% of SAH patients, respectively. The highest sensitivity was found for headache (58.9%), nausea/vomiting (46.9%) and neck pain (32.6%). Among conscious SAH patients these symptoms were found to have the strongest association with SAH (OR 27.0, 8.41 and 34.0, respectively). Inability to stand up, speech difficulty, or sweating were reported in 24.6%, 24.2%, and 22.8%. The most frequent combination of symptoms was headache and nausea/vomiting, which was reported in 41.6% of SAH patients. More than 90% of headaches were severe, but headache was not reported in 29.7% of conscious SAH patients. In these, syncope was described by 49.1% and nausea/vomiting by 37.7%. Conclusion Headache, nausea/vomiting, and neck pain had the highest sensitivity and strongest association with SAH in emergency telephone calls. Unspecific symptoms such as inability to stand up, speech difficulty or sweating were reported in 1 out of 5 calls. Interestingly, 1 in 3 conscious SAH patients did not report headache. Trial registration NCT03980613 (www.clinicaltrials.gov).

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<p>The positive predictive value of spontaneous subarachnoid hemorrhage diagnoses in the Danish National Patient Register</p>

Cited by 12 publications

References 25 publications

Frequency of Neurological Diseases After COVID-19, Influenza A/B and Bacterial Pneumonia

Frequency of Neurological Diseases After COVID-19, Influenza A/B and Bacterial Pneumonia

Risks of Stroke Recurrence and Mortality After First and Recurrent Strokes in Denmark

Symptoms presented during emergency telephone calls for patients with spontaneous subarachnoid haemorrhage

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