Outcomes of patients with transient ischaemic attack after hospital admission or discharge from the emergency department.
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).


METHODS
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.


METHODS
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).


CONCLUSIONS
Patients with an ED diagnosis of TIA may benefit from admission to hospital through a reduced risk of early stroke.
Kehdi
Elias E
EE
Neurology Department, Liverpool Hospital, Sydney, NSW, Australia.
Cordato
Dennis J
DJ
Thomas
Peter R
PR
Beran
Roy G
RG
Cappelen-Smith
Cecilia
C
Griffith
Neil C
NC
Hanna
Ibrahim Y
IY
McDougall
Alan J
AJ
Worthington
John M
JM
Hodgkinson
Suzanne J
SJ
D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*