@article{oai:hirosaki.repo.nii.ac.jp:00007174,
 author = {白戸, 弘志 and 萩井, 譲士 and 目時, 典文 and 齋藤, 新 and 佐々木, 都子 and 高橋, 広希 and 人見, 博康 and 馬場, 佳子 and 山田, 奈津美 and 清野, 聡 and 内沢, 隆充 and 中村, 太源 and 岩田, 学 and 鎌田, 孝篤 and 高梨, 信吾 and 富田, 泰史},
 issue = {1-4},
 journal = {弘前医学, Hirosaki Medical Journal},
 month = {Mar},
 note = {【背景及び目的】多くの脳卒中鑑別スケールは，診察所見を中心に構成される．脳卒中を疑う救急患者の神経症状の訴えと初診時バイタルサインが脳卒中診断に与える影響に関する報告は少なく，その有用性を検討した．
【方法】救急隊が脳卒中を疑い当センターへ搬送した患者461例を，脳卒中群ならびに非脳卒中（mimics）群の二群に分けた．神経症状の訴えと初診時バイタルサインをカルテより抽出し，後方視的に比較した．
【結果】片麻痺ならびに言語障害の訴え，収縮期血圧≧155 mmHg，心電図モニター上の心拍不整は有意に脳卒中群で多く，38.0℃以上の発熱，および低酸素血症はmimics 群で多かった．脳卒中診断を目的とした多変量解析においても，それぞれが独立した因子であった．一方で，口角下垂の訴えは単変量解析で有意ではなかった．
【結論】脳卒中を疑う救急搬入患者の神経症状の訴えと初診時バイタルサインは，脳卒中診断に有用であった．
Background: Most of the prehospital stroke scales are composed of physical assessments. The impact of subjective symptoms and vital signs on stroke diagnosis has been poorly evaluated.
Purpose: The objective of this study was to assess the effectiveness of subjective symptoms and vital signs to identify genuine stroke patients from those suspected of stroke.
Methods: We divided 461 suspected stroke patients into two groups: genuine stroke patients（n=268）and mimics patients（n=193）. We focused on the subjective symptoms and vital signs at admission and compared them between the two groups.
Results: The subjective symptoms of hemiparesis and speech abnormality, systolic blood pressure of > 155 mmHg, and irregular cardiac rhythm were more common in the stroke group than in the mimics group. Furthermore, these were all independent factors in multivariate analysis. Body temperature > 38.0 ℃ and hypoxemia were more found in the mimics group than in the stroke group. The facial droop was not a significant factor in univariate analysis.
Conclusion: The subjective symptoms and vital signs were useful predictors for stroke diagnosis.},
 pages = {1--9},
 title = {救急搬入患者の脳卒中診断鑑別における神経症状の訴えと初診時バイタルサインの有用性},
 volume = {73},
 year = {2023}
}