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Changes in survival after transient ischemic attacks: observations comparing the 1970s and 1980s
G Howard1, J K Brockschmidt, L A Rose
1Stroke Research Center, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Neurology
|July 1, 1989
Summary
Survival after transient ischemic attack (TIA) significantly improved over time. Patients admitted later showed greater longevity, highlighting advancements in TIA and stroke care.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Transient ischemic attack (TIA) is a critical warning sign for future stroke.
- Survival rates following TIA can vary based on the time period and patient cohort.
- Understanding temporal trends in TIA survival is crucial for assessing healthcare effectiveness.
Purpose of the Study:
- To compare survival outcomes between two distinct prospective cohorts of TIA patients.
- To identify potential factors contributing to changes in TIA patient longevity over time.
- To assess the comparability of TIA survival data reported across different historical periods.
Main Methods:
- Prospective cohort study design comparing two groups of TIA patients.
- Cohort 1: 177 patients admitted between 1961-1973.
- Cohort 2: 185 patients admitted between 1980-1983.
- Survival analysis performed univariately and adjusted for cerebrovascular risk factors.
Main Results:
- Patients in the second cohort (1980-1983) demonstrated significantly greater longevity than the first cohort (1961-1973).
- Adjusted 1-year survival increased from 91% to 98% between the cohorts.
- Adjusted 3-year survival increased from 83% to 94% between the cohorts.
Conclusions:
- There has been a substantial improvement in survival rates for patients experiencing transient ischemic attacks (TIAs) over time.
- Potential contributing factors include earlier TIA identification, aggressive management of comorbidities, and improved stroke/myocardial infarction care.
- Findings suggest that TIA survival data from different time periods may not be directly comparable due to evolving medical practices and patient outcomes.