Short-term prognosis after emergency department diagnosis of TIA
Short-term prognosis after emergency department diagnosis of TIA
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DOI：
10.1001/jama.284.22.2901
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发表时间：
2000-12-13
影响因子：
120.7
通讯作者：
Sidney, S
中科院分区：
文献类型：
--
作者：
Johnston, SC;Gress, DR;Sidney, S
背景对急性短暂性脑缺血发作(TIA)患者的管理差异很大，一些机构允许所有患者入院，另一些机构则继续进行门诊评估。目的确定急诊科诊断TIA后卒中和其他不良事件的短期风险。设计和设置1997年3月至1998年2月在加利福尼亚州北部一家卫生维护机构的16家医院进行的队列研究。共有1707名患者(平均年龄72岁)被急诊科医生确认为TIA患者。结果在短暂性脑缺血发作后的90天内，180例(10.5%)患者因中风回到急诊科，其中91例发生在前2天。与中风独立相关的因素有5个：年龄>60岁(优势比[OR]，1.8；95%可信区间[CI]，1.1-2.7；P=0.01)，糖尿病(OR，2.0；95%CI，1.4-2.9；P
Context Management of patients with acute transient ischemic attack (TIA) varies widely, with some institutions admitting all patients and others proceeding with outpatient evaluations. Defining the short-term prognosis and risk factors for stroke after TIA may provide guidance in determining which patients need rapid evaluation.Objective To determine the short-term risk of stroke and other adverse events after emergency department (ED) diagnosis of TIA.Design and Setting Cohort study conducted from March 1997 through February 1998 in 16 hospitals in a health maintenance organization in northern California.Patients A total of 1707 patients (mean age, 72 years) identified by ED physicians as having presented with TIA.Main Outcome Measures Risk of stroke during the 90 days after index TIA; other events, including death, recurrent TIA, and hospitalization for cardiovascular events.Results During the 90 days after index TIA, 180 patients (10.5%) returned to the ED with a stroke, 91 of which occurred in the first 2 days. Five factors were independently associated with stroke: age greater than 60 years (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1-2.7; P=.01), diabetes mellitus (OR, 2.0; 95% CI, 1.4-2.9; P