Evaluation of transient ischemic attack in an emergency department observation unit

Latha G. Stead, M. Fernanda Bellolio, Smitha Suravaram, Robert D. Brown, Anjali Bhagra, Rachel M. Gilmore, Eric T. Boie, Wyatt W. Decker

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)204-208
Number of pages5
JournalNeurocritical care
Volume10
Issue number2
DOIs
StatePublished - Apr 1 2009

Keywords

  • Emergency Department
  • Observation unit
  • Transient ischemic attack

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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