Differences in Clinical Characteristics between Patients with Transient Ischemic Attack Whose Symptoms Do and Do Not Persist on Arrival.
BACKGROUND
Symptoms of transient ischemic attack (TIA) persist on arrival and subsequently resolve in some patients admitted to hospitals early after onset. Differences in clinical characteristics between patients with acute TIA whose symptoms do and do not persist on arrival remain unclear.


METHODS
We retrospectively extracted data of consecutive TIA patients with an onset-to-door time (ODT) of 24 hours or less and without a history of stroke from a multicenter TIA database. Clinical characteristics were compared between patients with and without persisting symptoms on arrival.


RESULTS
Two hundred sixty-six patients (158 men, 68.0 ± 12.9 years) were included. Of the total number of patients, 105 (39.5%) had persisting symptoms with a mean National Institutes of Health Stroke Scale score of 2.4 (median, 1.0). Patients with persisting symptoms were more likely to have sensory disorder, ambulance-transported admission, long-duration TIA (≥60 minutes), and shorter ODT than those without. Multivariate analysis showed that sensory disorder (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.35-4.77), ambulance-transported admission (OR 1.80, 95% CI 1.00-3.28), and long-duration TIA (OR 3.96, 95% CI 2.12-7.71) were positively associated and that an ODT of more than 12 hours (OR .18, 95% CI .04-.63) was inversely associated with the presence ofpersisting symptoms. Patients with persisting symptoms were more likely to be examined by a stroke physician at first (69% versus 57%, P = .049) and then hospitalized in a stroke unit (59% versus 43%, P = .010).


CONCLUSIONS
Clinical manifestations and management after admission might differ between patients with acute TIA whose symptoms do and do not persist on arrival.
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Koji
K
Tanaka
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address: tuehara@ncvc.go.jp.
Toshiyuki
T
Uehara
Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
Kazumi
K
Kimura
Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Clinical Research Institute, Fukuoka, Japan.
Yasushi
Y
Okada
Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Yasuhiro
Y
Hasegawa
Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan.
Norio
N
Tanahashi
Department of Stroke Science, Research Institute for Brain and Blood Vessels Akita, Akita, Japan.
Akifumi
A
Suzuki
Department of Neurology, Tokai University Hospital, Isehara, Japan.
Shigeharu
S
Takagi
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan.
Jyoji
J
Nakagawara
Department of Neurology, Ebara Hospital, Tokyo, Japan.
Kazumasa
K
Arii
Department of Neurosurgery, Tokushima University Hospital, Tokushima, Japan.
Shinji
S
Nagahiro
Department of Neurosurgery, Iwate Medical University Hospital, Morioka, Japan.
Kuniaki
K
Ogasawara
Department of Neurology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Takehiko
T
Nagao
Department of Neurology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Shinichiro
S
Uchiyama
Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan.
Masayasu
M
Matsumoto
Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan.
Koji
K
Iihara
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Kazunori
K
Toyoda
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Kazuo
K
Minematsu
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D012189:Retrospective Studies; D012720:Severity of Illness Index
ABCD(2) score; Transient ischemic attack; ischemic stroke; persisting symptom; risk factor