| Titre : | Short-term prognosis after emergency department diagnosis of TIA. (2000) |
| Auteurs : | Sclaiborne JOHNSTON ; Warren-S BROWNER ; Daryl-R GRESS ; Stephen SIDNEY ; Division of Research. Kaiser-Permanente Northern California. Oakland. USA ; Neurovascular Service. Department of Neurology. University of California. San Francisco. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 284, n° 22, 2000) |
| Pagination : | 2901-2906 |
| Langues: | Anglais |
| Mots-clés : | Ischémie ; Encéphale ; Pronostic ; Court terme ; Facteur risque ; Accident cérébrovasculaire ; Prévalence ; Epidémiologie ; Etats Unis ; Amérique ; Adulte ; Homme ; Appareil circulatoire [pathologie] ; Système nerveux [pathologie] ; Vaisseau sanguin encéphale [pathologie] ; Vaisseau sanguin [pathologie] ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST 3oZpR0xS. Diffusion soumise à autorisation]. Context Management of patients with acute transient ischemic attack (TIA) varies widely, with some institutions admitting all patients and others proceeding with outpatient evaluations. Defining the short-term prognosis and risk factors for stroke after TIA may provide guidance in determining which patients need rapid evaluation. Objective To determine the short-term risk of stroke and other adverse events after emergency department (ED) diagnosis of TIA. Design and Setting Cohort study conducted from March 1997 through February 1998 in 16 hospitals in a health maintenance organization in northern California. Patients A total of 1707 patients (mean age, 72 years) identified by ED physicians as having presented with TIA. Main Outcome Measures Risk of stroke during the 90 days after index TIA ; other events, including death, recurrent TIA, and hospitalization for cardiovascular events. Results During the 90 days after index TIA, 180 patients (10.5%) returned to the ED with a stroke, 91 of which occurred in the first 2 days. Five factors were independently associated with stroke : age greater than 60 years (odds ratio [OR], 1.8 ; 95% confidence interval [CI], 1.1-2.7 ; P=01), diabetes mellitus (OR, 2.0 ; 95% Cl, 1.4-2.9 ; P<. 001), symptom duration longer than 10 minutes (OR, 2.3 ; 95% CI, 1.3-4.2 ; P=005), weakness (OR, 1.9 ; 95% CI, 1.4-2.6 ; P<. 001), and speech impairment (OR, 1.5 ; 95% Cl, 1.1-2.1 ; P=01). Stroke or other adverse events occurred in 428 patients (25. (...) |
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