title: The prognostic impact of the stroke unit concept after transient ischemic attack.
abstract: OBJECTIVE
  Transient ischemic attack (TIA) is associated with high short-term risk of stroke, especially in the early phase following the event. Data about the impact of the early hospitalization in a stroke unit on patients with TIA are sparse. This study compares the prognostic impact of the stroke unit concept with conventional care on patients with TIA.
  
  
  METHODS
  During a 30-month period (beginning April 2005), 878 patients (mean age, 70±12years; 44.3% female) with TIA admitted within 24h of symptom onset were prospectively evaluated. The adjusted logistic regression analyses were used to estimate the odds ratio for the stroke risk during hospitalization and the 90-day mortality.
  
  
  RESULTS
  Of 878 patients, 591 (67.3%) were treated in the stroke unit, and 287 (32.7%) underwent conventional care. Patients receiving stroke-unit care had significantly higher rates of cranial computed tomography (96.3% vs. 88.1%; P<.001) and brain-supplying artery ultrasound (97.1% vs. 91.3%; P<.001) investigations. The stroke risk during hospitalization was 1.7% in patients treated in stroke unit and 2.4% in patients received a conventional care. A relevant difference between the groups was not found (1.7% vs. 2.4%; P=.45). The 90-day mortality rate was 1.7% in the stroke unit group compared to 2.2% in the conventional care group (1.7% vs. 2.2%; P=.66). The adjusted logistic regression analyses revealed no difference in stroke rates (odds ratio, 0.68; 95% confidence interval, 0.24-1.9) and in the 90-day mortality (odds ratio, 0.63; 95% confidence interval, 0.2-1.96) between the stroke unit concept and conventional care.
  
  
  CONCLUSIONS
  The prognostic impact of the stroke unit care for patients with transient ischemic attack appears to be similar to that of the conventional care. Further randomized studies are needed to investigate the impact of stroke-unit care on patients with transient ischemic attack.
authors.affiliation: Department of Neurology, University of Lübeck, Lübeck, Germany. Mohamed.al-khaled@neuro.uni-luebeck.de
authors.forename: Mohamed
authors.initials: M
authors.lastname: Al-Khaled
authors.forename: Christine
authors.initials: C
authors.lastname: Matthis
authors.forename: Günter
authors.initials: G
authors.lastname: Seidel
mesh_terms: D000368:Aged; D019090:Case Management; D005260:Female; D017408:Guidelines as Topic; D006757:Hospital Units / Q000458:organization & administration*; D006760:Hospitalization; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011014:Pneumonia / Q000150:complications; D011379:Prognosis; D020521:Stroke / Q000628:therapy*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications