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A Comparative Analysis of Patient Demographics and Referral Trends Pre- and Post-Intervention of the TIA Pathway: A
Adenike Wejinya1, Victoria Butler2, Esther Mireku2,3
1School of Health & Life Sciences Teesside University Middlesbrough UK.
Background And Aims:
Timely diagnosis of Transient Ischaemic Attack (TIA) is critical for stroke prevention. This study evaluated referral patterns, demographic predictors, and diagnostic outcomes before and after a service improvement intervention at North Tees and Hartlepool NHS Foundation Trust.
Methods:
A retrospective observational study was conducted using 2,167 patient records from 2021 to 2024. Demographic and referral data were analysed using IBM SPSS Statistics v27. Chi-square analyses were used to assess associations between TIA diagnosis and age group, gender, local authority, and referral source (two-sided, p < 0.05). A multivariable logistic regression was performed to identify independent predictors, with odds ratios (ORs) and 95% confidence intervals (CIs) used to assess the strength and precision of associations.
Results:
The TIA diagnosis rate was 37.8%. Older adults (≥ 65 years) accounted for 72.3% of TIA cases. Digital referrals (Email and WebICE) increased significantly post-intervention, replacing GP and consultant routes. Consultant referrals, though rare, had the highest diagnostic yield (53.8%). Chi-square analysis showed significant associations between TIA diagnosis and age group, gender, local authority, and referral source (p < 0.05). In regression analysis (N = 1959), increasing age and consultant referrals were associated with higher odds of diagnosis. Middle deprivation was associated with slightly lower odds (OR = 0.77, p = 0.05). Gender was not a statistically significant predictor (p = 0.16).
Conclusion:
TIA diagnosis is strongly associated with age and referral source. Service changes improved referral standardisation, with digital pathways becoming the dominant mode of referral. Clinical judgment appears to play an important role, as reflected in the higher diagnostic yield of consultant referrals. These findings highlight the importance of considering key demographic and system-level factors in stroke prevention pathways.
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