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Outcomes of patients with transient ischaemic attack after hospital admission or discharge from the emergency department
Author(s) -
Kehdi Elias E,
Cordato Dennis J,
Thomas Peter R,
Beran Roy G,
CappelenSmith Cecilia,
Griffith Neil C,
Hanna Ibrahim Y,
McDougall Alan J,
Worthington John M,
Hodgkinson Suzanne J
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb01886.x
Subject(s) - medicine , emergency department , stroke (engine) , hospital admission , emergency medicine , hospital discharge , pediatrics , psychiatry , mechanical engineering , engineering
Objective: To compare outcomes at 28 days and 1 year between patients admitted to hospital and those discharged after presenting to the emergency department (ED) with transient ischaemic attack (TIA). Design and setting: All TIA presentations to EDs in a large metropolitan and rural region of Sydney and its surroundings, New South Wales, between 2001 and 2005 were extracted from state health department databases and followed up over 1 year. Admission and discharge data and subsequent TIA or stroke presentations were identified. Main outcome measures: TIA recurrence or stroke. Results: Of 2535 presentations to an ED with TIA during the 5‐year period, 1816 patients were admitted to hospital (71.6%) and 719 were discharged from the ED (28.4%). At 28 days, the discharged group had significantly higher rates of recurrence than the admitted group for all events (TIA or stroke) (5.3% v 2.3%, P < 0.001), stroke (2.1% v 0.7%, P = 0.002), and recurrent TIA (3.2% v 1.6%, P = 0.01). During the 29–365‐day follow‐up period, there was no significant difference between the discharged and admitted groups for all events (4.2% v 5.1%; P = 0.37), stroke (1.3% v 2.5%; P = 0.06) or recurrent TIA (2.9% v 2.6%; P = 0.65). Conclusion: Patients with an ED diagnosis of TIA may benefit from admission to hospital through a reduced risk of early stroke.