TY - JOUR
T1 - Evaluation of transient ischemic attack in an emergency department observation unit
AU - Stead, Latha G.
AU - Bellolio, M. Fernanda
AU - Suravaram, Smitha
AU - Brown, Robert D.
AU - Bhagra, Anjali
AU - Gilmore, Rachel M.
AU - Boie, Eric T.
AU - Decker, Wyatt W.
N1 - Funding Information:
Acknowledgments Dr. Stead is supported by a Mayo Foundation Emergency Medicine Research Career Development Award.
Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2009/4
Y1 - 2009/4
N2 - 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.
AB - 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.
KW - Emergency Department
KW - Observation unit
KW - Transient ischemic attack
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U2 - 10.1007/s12028-008-9146-z
DO - 10.1007/s12028-008-9146-z
M3 - Article
C2 - 18850077
AN - SCOPUS:66249101167
SN - 1541-6933
VL - 10
SP - 204
EP - 208
JO - Neurocritical care
JF - Neurocritical care
IS - 2
ER -