Evaluation of Transient Ischemic Attack in an Emergency Department Observation Unit
| Autor: | M. Fernanda Bellolio, Anjali Bhagra, Wyatt W. Decker, S. Suravaram, Rachel M. Gilmore, Eric T. Boie, Robert D. Brown, Latha G. Stead |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Neurology Comorbidity Critical Care and Intensive Care Medicine Risk Factors Diabetes mellitus Diabetes Mellitus Humans Medicine Prospective Studies cardiovascular diseases Prospective cohort study Stroke Aged Aged 80 and over business.industry Emergency department Middle Aged medicine.disease Clinical trial Early Diagnosis Ischemic Attack Transient Hypertension Emergency medicine Cohort Critical Pathways Physical therapy Feasibility Studies Female Neurology (clinical) Emergency Service Hospital business |
| Zdroj: | Neurocritical Care. 10 |
| ISSN: | 1556-0961 1541-6933 |
| Popis: | Objective To evaluate the feasibility of a protocol for evaluation of transient ischemic attack (TIA) in an Emergency Department Observation Unit (EDOU), and assess the risk of early stroke after such an evaluation. Methods All adult patients presenting to the Emergency Department (ED) with signs and symptoms consistent with TIA were prospectively enrolled in this observational study over a period of 3 years. Patients underwent a standardized TIA evaluation per protocol. Risk of subsequent stroke at 48 h, 1 week, 1 month, and 3 months was prospectively assessed. Results In total, 418 patients were seen during the study period, and all were evaluated per the EDOU TIA protocol. The mean age was 73.1 (±13.3) years and 53.8% were males. Comorbidities included hypertension in 71.5%, diabetes mellitus in 20.1%, prior TIA in 19.6%, and prior ischemic stroke in 19.6% of the cohort. Brain CT, neurology consult, electrocardiogram, carotid ultrasound, and additional tests were performed, and education was given. A total of 30.4% of the patients were dismissed directly from the EDOU. The risk of stroke at 2 days was 0.96%, at 7 days 1.2%, at 30 days 1.9%, and 2.4% at 90 days. Conclusion An Emergency Department Observation Unit Protocol for TIA is a feasible option for expedited evaluation of these patients. |
| Databáze: | OpenAIRE |
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