Stroke management in a general internal medicine department: results of a survey concerning practice.

Purpose. - The incidence of strokes in the general population and the insuf ficient numbers of centers specialized in their management has led to the i ncreased hospitalization of patients in general, internal medicine departme nts. The prognosis for patients is related to the relevance of the initial diagnostic and therapeutic measures. To optimize management of stroke patie nts outside of specialized units, a survey concerning practice was conducte d in internal medicine departments in western France, and a meeting was hel d to define guidelines. Methods. - Data sheets were mailed to practitioners in internal medicine de partments prior to the survey. The following data were recorded for each pa tient hospitalized during the two-week study: age, sex, clinical characteri stics of stroke, risk factors, investigations performed, and initial and su bsequent medical management. On the basis of the results, management guidel ines were considered and defined. Results. - Patients hospitalized fora stroke in internal medicine departmen ts have a similar profile to those hospitalized in neurology departments. C T-scan and EKG recordings were performed in most patients whereas other inv estigations (cervical ultrasound, echocardiography, MRI) were used less fre quently. The use of rehabilitation and therapeutic strategies for secondary stroke prevention were not always performed according to current guideline s. Conclusion. - Internal medicine departments are frequently involved in the care of stroke patients. The present study of clinical practice may help to improve stroke management in these nonspecialized departments. (C) 2001 Ed itions scientifiques et medicales Elsevier SAS.