Abstract WP370: The Swedish Quality Register for Transient Ischemic Attacks: design and initial results
INTRODUCTION: Several national quality registers for stroke have been established, but they have generally not included TIA, an essential part of acute cerebrovascular disease with a high preventive potential. We report the 1st results from the world’s 1st national quality register on TIA.
Methods: In 2011 a TIA module was added to the Swedish Stroke Register (Riks-Stroke). Indicators included basic demographics, risk factors, ABCD2 score, brain and vascular imaging, cardiac arrhythmia diagnostics, medical treatments, and anti-smoking advice.
Results: During the initial half-year (January to June 2011), 3293 TIA patients were registered at 55 of Sweden’s 75 hospitals. Mean age for men was 71.1 years and for women 74.6 years; 2 and 3.5 years lower than for stroke-patients registered in Riks-Stroke. Mean ABCD2 score was 4.1. Atrial fibrillation (AF) was recorded in 19 % of patients. 96.4 % were examined with CT, 8.1 % with MRI, 69.5 % with neck vessel imaging, and 31.4 % with Holter monitoring (with large variation across hospitals: 0-80 %). At discharge, 83.9 % were treated with antiplatelets whereas 10.8 % were treated with warfarin (57 % of those with AF). About two thirds were treated with blood pressure lowering drugs and statins, with substantial variation across hospitals. Of smokers (13 % overall), 85 % were given anti-smoking advice.
Conclusions: A national quality register for TIA is feasible. Compared to epidemiological data we estimate that the register currently covers about two thirds of all TIA in Sweden. Many aspects of diagnostics and therapy appeared satisfactory, but there were wide variations in cardiac arrhythmia diagnostics, and one third or more were not appropriately treated with warfarin, blood pressure lowering drugs, or statins.
- © 2012 by American Heart Association, Inc.