OBJECTIVE: To compare outcomes at 28 days and 1 year between patients admitted to hospital and those discharged after presenting to the emergency department (ED) with transient ischaemic attack (TIA). DESIGN AND SETTING: All TIA presentations to EDs in a large metropolitan and rural region of Sydney and its surroundings, New South Wales, between 2001 and 2005 were extracted from state health department databases and followed up over 1 year. Admission and discharge data and subsequent TIA or stroke presentations were identified. MAIN OUTCOME MEASURES: TIA recurrence or stroke. RESULTS: Of 2535 presentations to an ED with TIA during the 5-year period, 1816 patients were admitted to hospital (71.6%) and 719 were discharged from the ED (28.4%). At 28 days, the discharged group had significantly higher rates of recurrence than the admitted group for all events (TIA or stroke) (5.3% v 2.3%, P < 0.001), stroke (2.1% v 0.7%, P = 0.002), and recurrent TIA (3.2% v 1.6%, P = 0.01). During the 29-365-day follow-up period, there was no significant difference between the discharged and admitted groups for all events (4.2% v 5.1%; P = 0.37), stroke (1.3% v 2.5%; P = 0.06) or recurrent TIA (2.9% v 2.6%; P = 0.65). CONCLUSION: Patients with an ED diagnosis of TIA may benefit from admission to hospital through a reduced risk of early stroke.
OBJECTIVE: To compare outcomes at 28 days and 1 year between patients admitted to hospital and those discharged after presenting to the emergency department (ED) with transient ischaemic attack (TIA). DESIGN AND SETTING: All TIA presentations to EDs in a large metropolitan and rural region of Sydney and its surroundings, New South Wales, between 2001 and 2005 were extracted from state health department databases and followed up over 1 year. Admission and discharge data and subsequent TIA or stroke presentations were identified. MAIN OUTCOME MEASURES: TIA recurrence or stroke. RESULTS: Of 2535 presentations to an ED with TIA during the 5-year period, 1816 patients were admitted to hospital (71.6%) and 719 were discharged from the ED (28.4%). At 28 days, the discharged group had significantly higher rates of recurrence than the admitted group for all events (TIA or stroke) (5.3% v 2.3%, P < 0.001), stroke (2.1% v 0.7%, P = 0.002), and recurrent TIA (3.2% v 1.6%, P = 0.01). During the 29-365-day follow-up period, there was no significant difference between the discharged and admitted groups for all events (4.2% v 5.1%; P = 0.37), stroke (1.3% v 2.5%; P = 0.06) or recurrent TIA (2.9% v 2.6%; P = 0.65). CONCLUSION:Patients with an ED diagnosis of TIA may benefit from admission to hospital through a reduced risk of early stroke.
Authors: Dawn M Bravata; Laura J Myers; Greg Arling; Edward J Miech; Teresa Damush; Jason J Sico; Michael S Phipps; Alan J Zillich; Zhangsheng Yu; Mathew Reeves; Linda S Williams; Jason Johanning; Seemant Chaturvedi; Fitsum Baye; Susan Ofner; Curt Austin; Jared Ferguson; Glenn D Graham; Rachel Rhude; Chad S Kessler; Donald S Higgins; Eric Cheng Journal: JAMA Neurol Date: 2018-04-01 Impact factor: 18.302
Authors: Moira K Kapral; Ruth Hall; Jiming Fang; Peter C Austin; Frank L Silver; David J Gladstone; Leanne K Casaubon; Melissa Stamplecoski; Jack V Tu Journal: Neurology Date: 2016-03-25 Impact factor: 9.910
Authors: Barbara J Homoya; Teresa M Damush; Jason J Sico; Edward J Miech; Gregory W Arling; Laura J Myers; Jared B Ferguson; Michael S Phipps; Eric M Cheng; Dawn M Bravata Journal: J Gen Intern Med Date: 2018-11-27 Impact factor: 5.128