Kehdi Elias E, Cordato Dennis J, Thomas Peter R, Beran Roy G, Cappelen-Smith Cecilia, Griffith Neil C, Hanna Ibrahim Y, McDougall Alan J, Worthington John M, Hodgkinson Suzanne J
Neurology Department, Liverpool Hospital, Sydney, NSW, Australia.
Med J Aust. 2008 Jul 7;189(1):9-12. doi: 10.5694/j.1326-5377.2008.tb01886.x.
To compare outcomes at 28 days and 1 year between patients admitted to hospital and those discharged after presenting to the emergency department (ED) with transient ischaemic attack (TIA).
All TIA presentations to EDs in a large metropolitan and rural region of Sydney and its surroundings, New South Wales, between 2001 and 2005 were extracted from state health department databases and followed up over 1 year. Admission and discharge data and subsequent TIA or stroke presentations were identified.
TIA recurrence or stroke.
Of 2535 presentations to an ED with TIA during the 5-year period, 1816 patients were admitted to hospital (71.6%) and 719 were discharged from the ED (28.4%). At 28 days, the discharged group had significantly higher rates of recurrence than the admitted group for all events (TIA or stroke) (5.3% v 2.3%, P < 0.001), stroke (2.1% v 0.7%, P = 0.002), and recurrent TIA (3.2% v 1.6%, P = 0.01). During the 29-365-day follow-up period, there was no significant difference between the discharged and admitted groups for all events (4.2% v 5.1%; P = 0.37), stroke (1.3% v 2.5%; P = 0.06) or recurrent TIA (2.9% v 2.6%; P = 0.65).
Patients with an ED diagnosis of TIA may benefit from admission to hospital through a reduced risk of early stroke.
比较因短暂性脑缺血发作（TIA）入院患者与在急诊科（ED）就诊后出院患者在28天和1年时的结局。
从新南威尔士州悉尼及其周边一个大城市和农村地区的州卫生部门数据库中提取2001年至2005年期间所有在急诊科就诊的TIA病例，并进行为期1年的随访。确定入院和出院数据以及随后的TIA或卒中就诊情况。
TIA复发或卒中。
在5年期间，2535例在急诊科就诊的TIA患者中，1816例入院（71.6%），719例从急诊科出院（28.4%）。在28天时，出院组所有事件（TIA或卒中）、卒中以及复发性TIA的复发率均显著高于入院组（分别为5.3%对2.3%，P<0.001；2.1%对0.7%，P = 0.002；3.2%对1.6%，P = 0.01）。在29至365天的随访期内，出院组和入院组在所有事件（4.2%对5.1%；P = 0.37）、卒中（1.3%对2.5%；P = 0.06）或复发性TIA（2.9%对2.6%；P = 0.65）方面无显著差异。
急诊科诊断为TIA的患者入院可能因早期卒中风险降低而获益。
