The Burden of Stroke Mimics: Present and Future Projections

Abstract

An increasing proportion of patients presenting with suspected stroke prove to have other conditions, often referred to as stroke mimics. The aim of this study was to present a projection of the number of hospitalized strokes, transient ischemic attacks (TIAs), and stroke mimics in Norway up to the year 2050 based on expected demographic changes, to estimate the burden of stroke mimics in the coming decades. This prospective study included all admissions to the stroke unit of Akershus University Hospital from March 1, 2012, to February 28, 2013. Relevant resource use was recorded. Based on the age- and sex-specific absolute incidences for the study period, the expected numbers of strokes, TIAs, and stroke mimics in the entire Norwegian population were computed for every fifth year for the period 2020-2050. We included 1881 admissions, of which 38.2% were stroke mimics. With constant age- and sex-dependent incidence rates, we estimated that the number of strokes and stroke mimics will respectively increase by 121.3% and 88.7% (men) and 97.6% and 71.7% (women). For hospital admission levels to stay constant at the 2013 level, an annual reduction of 2.1% and 1.7% (men) and 1.8% and 1.5% (women) must take place for strokes and mimics, respectively. A significant proportion of stroke unit admissions prove to have other conditions than stroke. With constant age- and sex-dependent incidence rates, the number of stroke mimics admissions will increase substantially over the next decades.