title: Nationwide patterns of hospitalization after transient ischemic attack.
abstract: BACKGROUND
  Little is known about nationwide patterns of hospitalization after transient ischemic attack (TIA).
  
  
  METHODS
  In a nationally representative sample of Emergency Department (ED) visits included in the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 1997 through 2008, we estimated rates of hospitalization among patients with a primary ED diagnosis of TIA (International Classification of Diseases, 9th Revision (ICD-9), code 435). We used multiple logistic regression analysis to examine the association between hospitalization and demographic characteristics, geographic region, year of the visit, time of the visit, and markers of stroke risk.
  
  
  RESULTS
  On the basis of 782 cases of TIA sampled by the NHAMCS, 57% (95% confidence interval [CI], 52%-61%) of patients with TIA nationwide were hospitalized. A higher proportion of patients was hospitalized in 2003 to 2008 (62%; 95% CI, 56%-68%) than in 1997 to 2002 (52%; 95% CI, 46%-58%; P = .02). Compared with the US Northeast, patients were less likely to be hospitalized in the Midwest (odds ratio [OR], 0.5; 95% CI, .3-.9), the South (OR, 0.3; 95% CI, .2-.5), or the West (OR, 0.2; 95% CI, .1-.4). Compared with white patients, hospitalization was more likely among patients who were black (OR, 2.4; 95% CI, 1.3-4.5), Hispanic (OR, 3.8; 95% CI, 1.4-10.2), or of other races (OR, 3.5; 95% CI, 1.3-9.6). Patients with Medicaid were admitted less often than those with private insurance (OR, 0.3; 95% CI, .2-.8).
  
  
  CONCLUSIONS
  Nationwide patterns of hospitalization after TIA show significant regional and demographic variation. These results may provide a useful roadmap for efforts to improve systems of care for TIA across the country.
authors.affiliation: Department of Neurology and Neuroscience, Weill Cornell Medical College, New York, New York. Electronic address: hok9010@med.cornell.edu.
authors.forename: Hooman
authors.initials: H
authors.lastname: Kamel
authors.forename: Jahan
authors.initials: J
authors.lastname: Fahimi
authors.forename: Prasanthi
authors.initials: P
authors.lastname: Govindarajan
authors.forename: Babak B
authors.initials: BB
authors.lastname: Navi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States