Premium
National survey of management of transient ischaemic attack in Australia: Take Immediate Action
Author(s) -
Price Christopher J,
Blacker David J,
Grimley Rohan S,
Dewey Helen M,
Gerraty Richard P,
Koblar Simon A,
Denisenko Sonia M,
Storey Catherine E,
Bladin Christopher F,
Hill Kelvin M
Publication year - 2009
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.1326-5377.2009.tb02667.x
Subject(s) - medicine , stroke (engine) , unit (ring theory) , emergency medicine , acute stroke , magnetic resonance imaging , medical emergency , psychology , radiology , mechanical engineering , mathematics education , tissue plasminogen activator , engineering
Objective: To understand the current organisation of services for people with transient ischaemic attack (TIA) and the processes of assessment and management across Australian hospitals. Design and setting: Cross‐sectional survey in 2008 of 134 Australian hospitals, mostly urban centres that treat large numbers of stroke patients. Main outcome measures: Survey questions covered assessment, early management and follow‐up practices, as well as organisation of services for TIA. Results: Seventy‐four hospitals (55%) responded: 47 (64%) reported access to a stroke unit, and 19 (26%) to a specialist clinic for TIA. Initial assessment included blood tests, electrocardiogram and brain computed tomography at most sites (92%–94%), and carotid imaging at more than half (65%), but magnetic resonance imaging at only 3% of sites. A tool to stratify the risk of subsequent stroke was used at 38 sites (51%), more commonly in hospitals with a stroke unit than in those without such a unit (64% v 30%; P = 0.005). Treatment was initiated at the initial assessment at 42 sites (58%), more commonly at stroke unit than non‐stroke unit sites (68% v 37%; P = 0.007). Formalised policies for management of TIA patients were used at 38 sites (54%), with clear differences between sites with a stroke unit and those without (70% v 25%; P < 0.001). Conclusion: Access to rapid assessment and management services for TIA varies considerably between Australian hospitals. The presence of organised stroke care at a hospital leads to improved processes of care for patients presenting with TIA.