Table 2.
In‐Hospital Ischemic Stroke Workup by Study Period
| Diagnostic Test | 1993–1994 (n=1458) | 1999 (n=1455) | 2005 (n=1403) | 2010 (n=1475) | P for Time Trend |
|---|---|---|---|---|---|
| Standard tests, n (%) | |||||
| Complete workupa | 722 (50) | 837 (58) | 1036 (74) | 1144 (78) | <0.0001 |
| Cardiac assessment | 917 (63) | 1007 (69) | 1140 (81) | 1293 (88) | <0.0001 |
| ECG | 1329 (91) | 1358 (93) | 1344 (96) | 1451 (98) | |
| Telemetry | Not recorded | Not recorded | Not recorded | 1342 (91) | |
| History of AF | 218 (15) | 211 (14) | 204 (15) | 323 (22) | |
| Echocardiogram | 837 (57) | 917 (63) | 1085 (77) | 1224 (83) | |
| Extracranial arteries assessedb | 982 (67) | 1065 (73) | 1185 (84) | 1252 (85) | <0.0001 |
| Carotid ultrasound | 926 (64) | 924 (64) | 830 (59) | 900 (61) | |
| MRA | 118 (8) | 224 (15) | 684 (49) | 698 (47) | |
| Digital subtraction angiogram | 61 (4) | 70 (5) | 45 (3) | 35 (2) | |
| Carotid ultrasound and MRA | 82 (6) | 108 (7) | 339 (24) | 355 (24) | |
| Carotid ultrasound only | 809 (55) | 787 (54) | 482 (34) | 543 (37) | |
| MRA only | 36 (2) | 107 (7) | 330 (24) | 328 (22) | |
| Brain imaging | 1378 (94.5) | 1444 (99.2) | 1401 (99.9) | 1474 (99.9) | <0.0001 |
| CT of head | 1365 (94) | 1427 (98) | 1378 (98) | 1441 (98) | |
| MRI of brain | 259 (18) | 441 (30) | 932 (66) | 1096 (74) | |
| Risk factor screening, n (%) | |||||
| Lipids assessed | 749 (51) | 594 (41) | 982 (70) | 1264 (86) | <0.0001 |
| History of hyperlipidemia | 131 (9) | 294 (20) | 498 (36) | 737 (50) | |
| Lipid levels | 702 (48) | 384 (26) | 759 (54) | 1024 (69) | |
| Statin on admission | 37 (3) | 197 (14) | 390 (28) | 528 (36) | <0.0001 |
| Statin on discharge | Not recorded | Not recorded | 605 (43) | 850 (58) | <0.0001 |
| Diabetes mellitus assessed | Not recorded | Not recorded | 993 (71) | 1275 (86) | <0.0001 |
| History of diabetes mellitus | 398 (27) | 437 (30) | 441 (31) | 484 (33) | |
| Hemoglobin A1c | Not recorded | Not recorded | 269 (19) | 526 (36) | |
| Fasting glucose | Not recorded | Not recorded | 741 (53) | 1177 (80) | |
AF indicates atrial fibrillation; CT, computed tomography; MRA, magnetic resonance angiogram; MRI, magnetic resonance imaging.
a
Complete workup was considered to be assessment of extracranial carotids and history of atrial fibrillation or echocardiography.
b
Defined as having at least 1 of the following: carotid ultrasound, MRA, or digital subtraction angiogram.