Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, ASUGI, University of Trieste, Strada Di Fiume 447, 34100, Trieste, Italy.
Emergency Department, University Hospital and Health Services of Trieste, ASUGI, University of Trieste, Strada Di Fiume 447, 34100, Trieste, Italy.
Neurol Sci. 2024 Aug;45(8):3861-3867. doi: 10.1007/s10072-024-07443-6. Epub 2024 Mar 11.
Transient ischemic attack (TIA) is defined as a transient episode of neurologic dysfunction, without acute infarction or tissue injury lasting less than 24 h. Previous data suggest TIA precedes 15% of ischemic strokes, with a higher risk in the first week. Current practice guidelines advise evaluation through rapid neurological visit or admission to hospital. We provide data on TIA incidence in Trieste, and we compare three different types of assessment: day hospital (DH), stroke unit (SU), and emergency department/outpatients (ED).
This is a 5-year retrospective study of transient cerebrovascular events admitted in the University Hospital of Trieste (230.623 inhabitants), between 2016 and 2020. We calculated TIA prevalence in Trieste district's general population. Our primary endpoint is ischemic recurrences within 90 days, and we evaluate the possible association between different types of management.
TIA incidence rate was 0.54/1000 inhabitants. In the multivariate analysis remained significantly associated with primary endpoint: ABCD2 (OR 1.625, CI 95% 1.114-2.369, p = 0.012) and DH evaluation (OR 0.260, CI 95% 0.082-0.819, p = 0.021).
Incidence of TIA in Trieste district is in line with previous data. We demonstrate the crucial role of DH evaluation over the outpatient/ED in reducing overall mortality and recurrence rate. Prompt recognition of patients at high risk for cerebrovascular events and specialist follow-up may reduce the incidence of major vascular events and death.
短暂性脑缺血发作（TIA）被定义为短暂的神经功能障碍发作，无急性梗死或组织损伤，持续时间少于 24 小时。先前的数据表明，TIA 在前 15%的缺血性中风之前发生，在第一周风险更高。目前的实践指南建议通过快速神经学就诊或住院进行评估。我们提供了的里雅斯特 TIA 发病率的数据，并比较了三种不同的评估类型：日间医院（DH）、卒中单元（SU）和急诊部/门诊（ED）。
这是一项回顾性研究，研究对象为 2016 年至 2020 年间在的里雅斯特大学医院就诊的短暂性脑血管事件患者（230.623 名居民）。我们计算了的里雅斯特地区普通人群中的 TIA 患病率。我们的主要终点是 90 天内的缺血性复发，评估不同管理类型之间的可能关联。
TIA 发病率为 0.54/1000 居民。在多变量分析中，与主要终点仍有显著关联的因素为：ABCD2 评分（OR 1.625，95%CI 1.114-2.369，p=0.012）和 DH 评估（OR 0.260，95%CI 0.082-0.819，p=0.021）。
的里雅斯特地区 TIA 的发病率与先前的数据一致。我们证明了 DH 评估在降低总死亡率和复发率方面优于门诊/ED 的重要作用。及时识别出高风险的脑血管事件患者，并进行专科随访，可能会降低主要血管事件和死亡的发生率。
