Predictors of Hospitalization in Patients With Transient Ischemic Attack or Minor Ischemic Stroke.

Can J Neurol Sci 2016 Jul 30;43(4):523-8. Epub 2016 Mar 30.

1Institute for Clinical Evaluative Sciences,Toronto,Canada.

Background: Transient ischemic attack (TIA) and minor stroke are associated with a substantial risk of subsequent stroke; however, there is uncertainty about whether such patients require admission to hospital for their initial management. We used data from a clinical stroke registry to determine the frequency and predictors of hospitalization for TIA or minor stroke across the province of Ontario, Canada.

Methods: The Ontario Stroke Registry collects information on a population-based sample of all patients seen in the emergency department with acute stroke or TIA in Ontario. We identified patients with minor ischemic stroke or TIA included in the registry between April 1, 2008, and March 31, 2011, and used multivariable analyses to evaluate predictors of hospitalization.

Results: Our study sample included 8540 patients with minor ischemic stroke or TIA, 47.2% of whom were admitted to hospital, with a range of 37.6% to 70.3% across Ontario's 14 local health integration network regions. Key predictors of admission were preadmission disability, vascular risk factors, presentation with weakness, speech disturbance or prolonged/persistent symptoms, arrival by ambulance, and presentation on a weekend or during periods of emergency department overcrowding.

Conclusions: More than one-half of patients with minor stroke or TIA were not admitted to the hospital, and there were wide regional variations in admission patterns. Additional work is needed to provide guidance to health care workers around when to admit such patients and to determine whether discharged patients are receiving appropriate follow-up care.

Download full-text PDF

Source
http://dx.doi.org/10.1017/cjn.2016.12DOI Listing
July 2016
38 Reads

Publication Analysis

Top Keywords

stroke tia
16
patients minor
12
minor ischemic
12
ischemic stroke
12
minor stroke
12
stroke
10
tia minor
8
admitted hospital
8
stroke registry
8
emergency department
8
transient ischemic
8
predictors hospitalization
8
ischemic attack
8
patients
8
tia
6
minor
6
ischemic
5
integration network
4
network regions
4
health integration
4

References

(Supplied by CrossRef)

Similar Publications