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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Urgent neurology consultation from the ED for transient ischemic attack
Anthony S Kim1, Stephen Sidney, Allan L Bernstein
1Department of Neurology, University of California, San Francisco, 94143-0114, USA. akim@ucsf.edu
The American Journal of Emergency Medicine
|September 10, 2010
Summary
Urgent neurology consultation for transient ischemic attack (TIA) patients improved early stroke risk but not 90-day outcomes. Consultation was linked to better care, though not exclusively for high-risk individuals.
Area of Science:
- Neurology
- Emergency Medicine
- Public Health
Background:
- Transient ischemic attack (TIA) is a critical warning sign for stroke.
- Effective management of TIA is crucial to prevent future cerebrovascular events.
- The role of urgent neurology consultation in TIA patient outcomes requires further investigation.
Purpose of the Study:
- To assess the association between urgent neurology consultation and patient outcomes following a transient ischemic attack (TIA).
Main Methods:
- Secondary analysis of 1707 emergency department patients diagnosed with TIA.
- Comparison of presentation, management, and outcomes based on neurology consultation status.
- Statistical adjustment for ABCD(2) scores and facility clustering using generalized estimating equations and survival analysis.
Main Results:
- Neurology consultation was obtained in 28% of TIA patients.
- Consultation correlated with increased hospital admission and antithrombotic use.
- A significantly lower cumulative stroke risk was observed within 1 week post-consultation (5.3% vs. 7.5%).
Conclusions:
- Urgent neurology consultation in TIA patients was associated with improved early stroke risk and quality of care indicators.
- Consultation was not preferentially given to patients with higher ABCD(2) scores.
- No significant improvement in 90-day stroke outcomes was established with urgent neurology consultation.
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