Differences in Clinical Characteristics between Patients with Transient Ischemic Attack Whose Symptoms Do and Do Not Persist on Arrival

Background Symptoms of transient ischemic attack (TIA) persist on arrival and subsequently resolve in some patients admitted to hospitals early after onset. Differences in clinical characteristics between patients with acute TIA whose symptoms do and do not persist on arrival remain unclear. Methods...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2016-09, Vol.25 (9), p.2237-2242
Main Authors: Tanaka, Koji, MD, Uehara, Toshiyuki, MD, Kimura, Kazumi, MD, Okada, Yasushi, MD, Hasegawa, Yasuhiro, MD, Tanahashi, Norio, MD, Suzuki, Akifumi, MD, Takagi, Shigeharu, MD, Nakagawara, Jyoji, MD, Arii, Kazumasa, MD, Nagahiro, Shinji, MD, Ogasawara, Kuniaki, MD, Nagao, Takehiko, MD, Uchiyama, Shinichiro, MD, Matsumoto, Masayasu, MD, Iihara, Koji, MD, Toyoda, Kazunori, MD, Minematsu, Kazuo, MD
Format: Article
Language:English
Subjects:
ABCD2 score
Aged
Aged, 80 and over
Cardiovascular
Female
Hospitalization
Humans
Ischemic Attack, Transient - diagnosis
Ischemic Attack, Transient - physiopathology
Ischemic Attack, Transient - therapy
ischemic stroke
Male
Middle Aged
Neuroimaging
Neurology
persisting symptom
Retrospective Studies
risk factor
Severity of Illness Index
Transient ischemic attack
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Summary:Background Symptoms of transient ischemic attack (TIA) persist on arrival and subsequently resolve in some patients admitted to hospitals early after onset. Differences in clinical characteristics between patients with acute TIA whose symptoms do and do not persist on arrival remain unclear. Methods We retrospectively extracted data of consecutive TIA patients with an onset-to-door time (ODT) of 24 hours or less and without a history of stroke from a multicenter TIA database. Clinical characteristics were compared between patients with and without persisting symptoms on arrival. Results Two hundred sixty-six patients (158 men, 68.0 ± 12.9 years) were included. Of the total number of patients, 105 (39.5%) had persisting symptoms with a mean National Institutes of Health Stroke Scale score of 2.4 (median, 1.0). Patients with persisting symptoms were more likely to have sensory disorder, ambulance-transported admission, long-duration TIA (≥60 minutes), and shorter ODT than those without. Multivariate analysis showed that sensory disorder (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.35-4.77), ambulance-transported admission (OR 1.80, 95% CI 1.00-3.28), and long-duration TIA (OR 3.96, 95% CI 2.12-7.71) were positively associated and that an ODT of more than 12 hours (OR .18, 95% CI .04-.63) was inversely associated with the presence ofpersisting symptoms. Patients with persisting symptoms were more likely to be examined by a stroke physician at first (69% versus 57%, P  = .049) and then hospitalized in a stroke unit (59% versus 43%, P  = .010). Conclusion Clinical manifestations and management after admission might differ between patients with acute TIA whose symptoms do and do not persist on arrival.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2016.04.025