Abstract TP402: TIA Evaluation - Is Hospitalization Really Necessary?
Objective: A transient ischemic attack (TIA) is a major risk factor for a future disabling stroke. This risk can be lowered by the immediate evaluation of stroke risk factors and rapid intervention. TIA patients are generally admitted to the hospital for this evaluation, but this can take several days, and even then, their evaluation may be incomplete. We have started an outpatient open-access TIA rapid evaluation center at our medical center for comprehensive determination of stroke risk factors. We conducted a retrospective utilization and outcome review of all TIA patients hospitalized at our medical center over the last four years to help validate our new outpatient model.
Methods: We identified 398 patients admitted with either an admission or discharge diagnosis of TIA, reviewed their charts to calculate an ABCD2 score, for diagnostic testing and treatment, and then checked for readmissions within the subsequent 90 days for further TIAs or stroke.
Results: Only 5% of our patients admitted with TIA had recurrent cerebrovascular events within 90 days, none during their initial hospitalization. Despite a mean three-day length of stay, not all TIA patients underwent the complete diagnostic evaluation we are offering in our outpatient center. The ABCD2 score correlated with subsequent TIA and stroke, and in particular an ABCD2 score of 6-7 indicated a higher stroke risk.
Conclusion: Recent TIA patients, particularly those with an ABCD2 score of 0-5, can be safely and more expeditiously evaluated as outpatients.
- © 2012 by American Heart Association, Inc.