Epidemiology and Management of Transient Ischemic Attack in Trieste District, How Day Hospital Assessment Improves Outcomes: a Five-year Retrospective Study

Overview

Journal Neurol Sci

Specialty Neurology

Date 2024 Mar 12

PMID 38467952

Authors

Paola Caruso

Gabriele Prandin

Lucrezia Rossi

Matteo Cegalin

Carlo Lugnan

Fulvio Pasquin

Ugo Giulio Sisto

Giovanni Furlanis

Marcello Naccarato

Franco Cominotto

Paolo Manganotti

Affiliations

Soon will be listed here.

Abstract

Background: Transient ischemic attack (TIA) is defined as a transient episode of neurologic dysfunction, without acute infarction or tissue injury lasting less than 24 h. Previous data suggest TIA precedes 15% of ischemic strokes, with a higher risk in the first week. Current practice guidelines advise evaluation through rapid neurological visit or admission to hospital. We provide data on TIA incidence in Trieste, and we compare three different types of assessment: day hospital (DH), stroke unit (SU), and emergency department/outpatients (ED).

Methods: This is a 5-year retrospective study of transient cerebrovascular events admitted in the University Hospital of Trieste (230.623 inhabitants), between 2016 and 2020. We calculated TIA prevalence in Trieste district's general population. Our primary endpoint is ischemic recurrences within 90 days, and we evaluate the possible association between different types of management.

Results: TIA incidence rate was 0.54/1000 inhabitants. In the multivariate analysis remained significantly associated with primary endpoint: ABCD2 (OR 1.625, CI 95% 1.114-2.369, p = 0.012) and DH evaluation (OR 0.260, CI 95% 0.082-0.819, p = 0.021).

Conclusions: Incidence of TIA in Trieste district is in line with previous data. We demonstrate the crucial role of DH evaluation over the outpatient/ED in reducing overall mortality and recurrence rate. Prompt recognition of patients at high risk for cerebrovascular events and specialist follow-up may reduce the incidence of major vascular events and death.

Citing Articles

Clinical characteristics and management of functional neurological disorders (FND) mimicking stroke in emergency settings: a functional stroke mimic cases.

Caruso P, Radin Y, Mancinelli L, Quagliotto M, Lombardo T, Pavan S Front Neurol. 2024; 15:1461320.

PMID: 39296954 PMC: 11409424. DOI: 10.3389/fneur.2024.1461320.

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