title: An Analysis of Transient Ischemic Attack Practices: Does Hospital Admission Improve Patient Outcomes?
abstract: BACKGROUND
  Immediate treatment has been shown to decrease the recurrence of cerebrovascular accidents following transient ischemic attacks (TIA), prompting the use of a specialized neurologic emergency department (Neuro ED) to triage patients. Despite these findings, there is little evidence supporting the notion that hospital admission improves post-TIA outcomes. Through the lens of a Neuro ED, this retrospective chart review of TIA patients examines whether hospital admission improves 90-day outcomes.
  
  
  METHODS
  Two hundred sixty charts of patients discharged with TIA diagnosis were reviewed. These charts encompassed patients with TIA who presented to a main emergency department (ED) or Neuro ED from January 2014 to April 2015. Demographic information, admission ABCD(2) scores, admission National Institutes of Health Stroke Scale scores, and admission Modified Rankin Scale, and reason for any return visits within 90 days were collected.
  
  
  RESULTS
  This review shows that patients triaged by the Neuro ED were admitted at a lower rate than those seen by the standard ED. Further, patients triaged by the Neuro ED experienced lower readmission and recurrence of stroke or TIA within 90 days.
  
  
  CONCLUSIONS
  These results provide preliminary support for the notion that discharging appropriate TIA patients, with adequate follow-up, will not adversely affect the recurrence of TIA or stroke within 90 days.
authors.affiliation: Drexel University College of Medicine, Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Lesenskyj
authors.affiliation: Drexel University College of Medicine, Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Maxwell
authors.affiliation: Drexel University College of Medicine, Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Erol
authors.initials: E
authors.lastname: Veznedaroglu
authors.affiliation: Drexel University College of Medicine, Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Liebman
authors.affiliation: Drexel University College of Medicine, Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Hakma
authors.affiliation: Drexel University College of Medicine, Drexel Neurosciences Institute, Philadelphia, Pennsylvania. Electronic address: Mbinning@gnineuro.org.
authors.forename: Mandy J
authors.initials: MJ
authors.lastname: Binning
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D002546:Ischemic Attack, Transient / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Transient ischemic attack; cerebrovascular accident; emergency department; stroke