The prognostic impact of the stroke unit concept after transient ischemic attack

Author(s): Al-Khaled M, Matthis C, Seidel G


Background and purpose: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.

Conclusion: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.

Similar Articles

Prognosis of transient ischemic attacks in the Oxfordshire Community Stroke Project

Author(s): Dennis M, Bamford J, Sandercock P, Warlow C

Short-term prognosis after emergency department diagnosis of TIA

Author(s): Johnston SC, Gress DR, Browner WS, Sidney S

Transient ischemic attacks in rural and urban northern Portugal: incidence and short-term prognosis

Author(s): Correia M, Silva MR, Magalhães R, Guimarães L, Silva MC

Stroke-unit care for acute stroke patients: an observational follow-up study

Author(s): Candelise L, Gattinoni M, Bersano A, Micieli G, Sterzi R, et al.

National Stroke Association guidelines for the management of transient ischemic attacks

Author(s): Johnston SC, Nguyen-Huynh MN, Schwarz ME, Fuller K, Williams CE, et al.

Guidelines for management of ischaemic stroke and transient ischaemic attack 2008

Author(s): European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee

Diagnosis of transient ischemic attack by the nonneurologist

Author(s): Ferro JM, Falcão I, Rodrigues G, Canhão P, Melo TP, et al.

A prospective cohort study of patients with transient ischemic attack to identify high-risk clinical characteristics

Author(s): Perry JJ, Sharma M, Sivilotti ML, Sutherland J, Worster A, et al.

TIA triage in emergency department using acute MRI (TIA-TEAM): A feasibility and safety study

Author(s): Vora N, Tung CE, Mlynash M, Garcia M, Kemp S, et al.

In-hospital initiation of secondary stroke prevention therapies yields high rates of adherence at follow-up

Author(s): Ovbiagele B, Saver JL, Fredieu A, Suzuki S, Selco S, et al.

Trends over time in the risk of stroke after an incident transient ischemic attack

Author(s): Sundararajan V, Thrift AG, Phan TG, Choi PM, Clissold B, et al.