Trends Over Time in the Risk of Stroke After an Incident Transient Ischemic Attack

Stroke ◽  
2014 ◽  
Vol 45 (11) ◽  
pp. 3214-3218 ◽  
Author(s):  
Vijaya Sundararajan ◽  
Amanda G. Thrift ◽  
Thanh G. Phan ◽  
Philip M. Choi ◽  
Ben Clissold ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Trends Over Time ◽  
Ischemic Attack ◽  
Over Time

Reduction in Stroke After Transient Ischemic Attack in a Province-Wide Cohort Between 2003 and 2015

2020 ◽  
pp. 1-9
Author(s):  
Ryan Wang ◽  
Arunima Kapoor ◽  
Patrice Lindsay ◽  
Cristina Goia ◽  
Amy Y. X. Yu ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Mortality Rates ◽  
Canadian Institute ◽  
Trends Over Time ◽  
Level 1 ◽  
Ischemic Attack ◽  
Event Rates ◽  
Linear Regressions ◽  
Over Time

ABSTRACT: Background: Improvements in management of transient ischemic attack (TIA) have decreased stroke and mortality post-TIA. Studies examining trends over time on a provincial level are limited. We analyzed whether efforts to improve management have decreased the rate of stroke and mortality after TIA from 2003 to 2015 across an entire province. Methods: Using administrative data from the Canadian Institute for Health Information’s (CIHI) databases from 2003 to 2015, we identified a cohort of patients with a diagnosis of TIA upon discharge from the emergency department (ED). We examined stroke rates at Day 1, 2, 7, 30, 90, 180, and 365 post-TIA and 1-year mortality rates and compared trends over time between 2003 and 2015. Results: From 2003 to 2015 in Ontario, there were 61,710 patients with an ED diagnosis of TIA. Linear regressions of stroke after the index TIA showed a significant decline between 2003 and 2015, decreasing by 25% at Day 180 and 32% at 1 year (p < 0.01). The 1-year stroke rate decreased from 6.0% in 2003 to 3.4% in 2015. Early (within 48 h) stroke after TIA continued to represent approximately half of the 1-year event rates. The 1-year mortality rate after ED discharge following a TIA decreased from 1.3% in 2003 to 0.3% in 2015 (p < 0.001). Interpretation: At a province-wide level, 1-year rates of stroke and mortality after TIA have declined significantly between 2003 and 2015, suggesting that efforts to improve management may have contributed toward the decline in long-term risk of stroke and mortality. Continued efforts are needed to further reduce the immediate risk of stroke following a TIA.

Abstract T P189: Time Trends in Transient Ischemic Attack Admission From the Emergency Department

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Karen Albright ◽  
John Donnelly ◽  
Michael Mullen ◽  
Brett Cucchiara ◽  
Justin Blackburn ◽  
...  
Keyword(s):  
Emergency Department ◽  
Risk Stratification ◽  
Transient Ischemic Attack ◽  
Practice Change ◽  
Time Period ◽  
Care Survey ◽  
Time Periods ◽  
Ischemic Attack ◽  
Ambulatory Medical Care ◽  
Over Time

Background: Prior studies suggest transient ischemic attack (TIA) admission from the Emergency Department (ED) increased over time. We investigated how TIA admission trends may have changed with publication of TIA risk stratification rules involving the ABCD /ABCD2 scores. Methods: We used ED data on TIA from the National Hospital Ambulatory Medical Care Survey. We defined three time periods to account for the initial publication by Johnston et al., highlighting the risk of ischemic stroke following TIA (2000) and related reports on the ABCD (2005) and ABCD2 (2007) scores. We defined 2005 through 2007 as a washout period to allow for any practice change that occurred with the evolution of ABCD/ABCD2 scores. Admission trends were stratified across younger (18-64y) and older (65y+) patients. Results: There were 327,339 TIA visits yearly from 1994 to 2010 in adults 18+ years. We compared three distinct time periods (1994-1999; 2001-2004 and 2008-2010 to reflect the timing of publications above. We observed interaction between time and age with regard to TIA admission (Figure). TIA patients 18-64y showed a decreasing admission trend overall (p = 0.047). Patients 65y+ showed a similar decreasing trend up to 2005-2007, but after 2007 had a marked increase in TIA admissions (p = 0.021). A comparison of stroke admissions during the same time period did not show an increasing trend in the 65+ group. Conclusion: Contrary to prior reports, TIA admissions decreased over time among persons 18-64y. Among older persons 65+, there was a sharp increase in TIA admission after 2007 that was not due to an increase in admissions for stroke or stroke-related diagnosis. The increase in TIA admissions could be related to new tools for the risk-stratification of TIA patients, but a large percentage of TIA patients are discharged from the ED. More research is needed to ensure that all high risk TIA patients receive a rapid evaluation.

Transient Ischemic Attack (TIA): A Problem Not to Miss

2017 ◽  
Vol 48 (S 01) ◽  
pp. S1-S45
Author(s):  
N. Plesko-Altermatt ◽  
S. Grunt ◽  
M. Diepold ◽  
E. Perret-Hoigné ◽  
T. Horvath ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Ischemic Attack
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