Outcomes of atherothrombotic transient ischemic attack and minor stroke in an emergency department: results of an outpatient management program.
OBJECTIVE
Management of patients with transient ischemic attack varies widely. The aim of this study is to analyze the outcomes of patients with transient ischemic attacks or minor stroke managed in the emergency department (ED) on an outpatient basis and to identify risk factors associated with stroke recurrence.


METHODS
We prospectively analyzed 97 patients with transient ischemic attack or minor stroke who were treated with a standard diagnostic and therapeutic protocol in the ED by emergency physicians. Factors in previous reports were analyzed in relation with a new neurologic event at 90 days or the presence of a severe extracranial carotid stenosis.


RESULTS
Incidence of recurrent transient ischemic attack or stroke was 7.2% at 24 hours, 9.3 % at 1 week, and 23.7 % at 3 months. Overall incidence of moderate to severe stroke was 0%, 1%, and 5% at the same points, and in outpatients was 0%, 0%, and 4.2%. ABCD2 scoring in these patients predicted stroke rates of 6% at 7 days and 9.9% at 90 days.


CONCLUSIONS
Patients with transient ischemic attack of atherothrombotic origin can be safely treated at the ED with an exhaustive diagnostic and therapeutic protocol. The rates of stroke recurrence obtained in our study are comparable with those in previous studies that show low recurrence risk.
Emergency Department, Hospital Infanta Cristina, Parla, Spain. jtorresmacho@hotmail.com
Juan
J
Torres Macho
Gabriela
G
Peña Lillo
David
D
Pérez Martínez
Ana
A
González Mansilla
Sergio
S
Gámez Díez
Salvador
S
Mateo Alvarez
Gonzalo
G
García de Casasola
D000368:Aged; D016893:Carotid Stenosis / Q000175:diagnosis / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome