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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Factors associated with onset-to-door time in patients with transient ischemic attack admitted to stroke centers
Toshiyuki Uehara1, Kazumi Kimura, Yasushi Okada
1From the Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (T.U., K.M.); Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan (K.K.); Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan (Y.O.); Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan (Y.H.); Department of Neurology and Cerebrovascular Medicine, Saitama Medical University Saitama International Medical Center, Hidaka, Japan (N.T.); Department of Stroke Science, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan (A.S); Department of Neurology, Tokai University, Isehara, Japan (S.T.); Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan (J.N.); Department of Neurology, Ebara Hospital, Tokyo, Japan (K.A.); Department of Neurosurgery, Tokushima University, Tokushima, Japan (S.N.); Department of Neurosurgery, Iwate Medical University, Morioka, Japan (K.O); Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan (T.N., S.U.); Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan (M.M.); and Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan (K.I.).
Background And Purpose:
The aim of this study was to elucidate the factors associated with the time from symptom onset to arrival at a stroke center (onset-to-door time [ODT]) in patients with classically defined transient ischemic attack using data from a multicenter, retrospective study.
Methods:
The subjects were patients with transient ischemic attack admitted to 13 stroke centers in Japan within 7 days of onset between 2008 and 2009. A total of 464 patients registered (292 men, 68.5±13.2 years old), and 421 of them (268 men, 68.8±13.1 years old) were included in the analyses. ODT was classified into the following 5 categories: <3 hours, 3 to 6 hours, 7 to 12 hours, 13 to 24 hours, and >24 hours.
Results:
There were 233 patients (55.3%) who visited a stroke center within 3 hours of symptom onset. Multiple ordinal logistic regression analysis revealed that motor weakness, speech disturbance, and duration of symptoms >10 minutes were independently associated with a short ODT. Furthermore, a history of transient ischemic attack and hypertension and a referral from another medical facility were independently associated with a long ODT. Patients with a higher ABCD2 score were likely to arrive at a stroke center more quickly.
Conclusions:
We identified several factors that were positively and negatively associated with the ODT in patients with transient ischemic attack.
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