title: Urgent neurology consultation from the ED for transient ischemic attack.
abstract: OBJECTIVE
  The objective of this study was to evaluate the association between urgent neurology consultation and outcomes for patients with transient ischemic attack (TIA).
  
  
  METHODS
  In a secondary analysis of data from 1707 emergency department patients with transient ischemic attack from March 1997 to May 1998, we compared presentation, management, and outcomes by neurology consultation status using generalized estimating equations to adjust for ABCD(2) score and clustering by facility and survival analysis for outcomes.
  
  
  RESULTS
  Consultation was obtained f28% of patients. Median ABCD(2) scores were comparable, but consultation was associated with hospital admission (odds ratio, 1.35 [1.02-1.78], P = .04) and use of antithrombotics (odds ratio, 1.88 [1.20-2.93], P = .005). The cumulative stroke risk was significantly lower within 1 week (5.3% versus 7.5%, P = .02) but not at 90 days (9.9% versus 11.0%, P = .21).
  
  
  CONCLUSIONS
  Consultation was not targeted to high-risk patients but was associated with some quality of care measures and improved early outcomes; however, improvement in 90-day outcomes was not established.
authors.affiliation: Department of Neurology, University of California, San Francisco, 94143-0114, USA. akim@ucsf.edu
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Kim
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
authors.forename: Allan L
authors.initials: AL
authors.lastname: Bernstein
authors.forename: Vanja C
authors.initials: VC
authors.lastname: Douglas
authors.forename: S Claiborne
authors.initials: SC
authors.lastname: Johnston
mesh_terms: D000368:Aged; D003657:Decision Making; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009462:Neurology; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis
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