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Ann Emerg Med ; 57(5): 510-6, 2011 May.
Article in English | MEDLINE | ID: mdl-21131102

ABSTRACT

STUDY OBJECTIVE: Management of patients with transient ischemic attack varies widely. The aim of this study is to analyze the outcomes of patients with transient ischemic attacks or minor stroke managed in the emergency department (ED) on an outpatient basis and to identify risk factors associated with stroke recurrence. METHODS: We prospectively analyzed 97 patients with transient ischemic attack or minor stroke who were treated with a standard diagnostic and therapeutic protocol in the ED by emergency physicians. Factors in previous reports were analyzed in relation with a new neurologic event at 90 days or the presence of a severe extracranial carotid stenosis. RESULTS: Incidence of recurrent transient ischemic attack or stroke was 7.2% at 24 hours, 9.3 % at 1 week, and 23.7 % at 3 months. Overall incidence of moderate to severe stroke was 0%, 1%, and 5% at the same points, and in outpatients was 0%, 0%, and 4.2%. ABCD2 scoring in these patients predicted stroke rates of 6% at 7 days and 9.9% at 90 days. CONCLUSION: Patients with transient ischemic attack of atherothrombotic origin can be safely treated at the ED with an exhaustive diagnostic and therapeutic protocol. The rates of stroke recurrence obtained in our study are comparable with those in previous studies that show low recurrence risk.


Subject(s)
Emergency Service, Hospital , Ischemic Attack, Transient/therapy , Stroke/therapy , Aged , Carotid Stenosis/diagnosis , Carotid Stenosis/therapy , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Incidence , Ischemic Attack, Transient/diagnosis , Kaplan-Meier Estimate , Male , Prognosis , Prospective Studies , Recurrence , Risk Factors , Severity of Illness Index , Stroke/diagnosis , Time Factors , Treatment Outcome
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