Patients With Transient Ischemic Attack or Minor Stroke Should Be Admitted to Hospital: For
Patients With Transient Ischemic Attack or Minor Stroke Should Be Admitted to Hospital: For
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短暂性脑缺血发作或轻微中风的患者应入院治疗：
作者：
Michael D. Hill;David J. Gladstone
短暂性脑缺血发作(TIA)与其他血管疾病一样，无论是急性肢体缺血还是急性冠脉综合征，都是高危、不稳定的疾病。TIA预示着相对较高的中风风险，在接下来的90天内可变地估计在10%到20%之间。1-4这已经被知道了几十年。5-8新的报道表明，至少一半的早期中风风险在TIA后的头两天累积。因此，任何保护性战略都必须迅速实施。
令人惊讶的是，对于像短暂性脑缺血发作这样常见和严重的疾病，急性治疗中仍然存在如此多的变异性。在一些机构，短暂性脑缺血发作患者是常规入院的，而在其他司法管辖区，短暂性脑缺血发作患者经常在管理不佳的情况下从急诊科出院，许多出院的短暂性脑缺血发作患者不太可能在30天内得到充分的门诊评估或治疗。
虽然住院卒中单元的价值已经确立，但对于短暂性脑缺血发作或轻度卒中患者的急性观察和调查单元的价值却知之甚少。短期住院的一些潜在好处包括：(1)加快诊断评估；(2)监测波动的患者，如果病情恶化，随时可以进行溶栓治疗；(3)促进早期颈动脉血管重建；以及(4)…
Transient ischemic attacks (TIAs), like other vascular diseases, whether acute limb ischemia or acute coronary syndromes, are high-risk, unstable conditions. TIA heralds a relatively high risk of stroke, variably estimated to range between 10% and 20% in the ensuing 90 days.1–4 This has been known for several decades.5–8 What is new are reports that show that at least half of the risk of early stroke accrues in the first 2 days after TIA. Necessarily then, any protective strategy needs to be implemented rapidly.
It is surprising that for a condition as common and serious as TIA, there remains so much variability in acute management. Whereas in some institutions, TIA patients are admitted routinely, in other jurisdictions, TIA patients are frequently discharged from the emergency department with suboptimal management, and many discharged TIA patients are unlikely to obtain adequate evaluation or treatment on an outpatient basis within 30 days.4
Although the value of inpatient stroke units is well established, little is known about the value of acute observation and investigation units for patients with TIA or minor stroke. Some potential benefits of a short-stay hospital admission include: (1) expedited diagnostic evaluation; (2) monitoring of fluctuating patients with ready access to thrombolysis if they deteriorate; (3) facilitation of early carotid revascularization; and (4) …
影响因子：
120.7
作者：
Johnston, SC;Gress, DR;Sidney, S
通讯作者：
Sidney, S