Delay in patients suspected of transient ischaemic attack: a cross-sectional study

BMJ Open
L Servaas DolmansFrans H Rutten

Abstract

Suspected transient ischaemic attack (TIA) necessitates an urgent neurological consultation and a rapid start of antiplatelet therapy to reduce the risk of early ischaemic stroke following a TIA. Guidelines for general practitioners (GPs) emphasise the urgency to install preventive treatment as soon as possible. We aimed to give a contemporary overview of both patient and physician delay. A survey at two rapid-access TIA outpatient clinics in Utrecht, the Netherlands. All patients suspected of TIA were interviewed to assess time delay to diagnosis and treatment, including the time from symptom onset to (1) the first contact with a medical service (patient delay), (2) consultation of the GP and (3) assessment at the TIA outpatient clinic. We used the diagnosis of the consulting neurologist as reference. Of 93 included patients, 43 (46.2%) received a definite, 13 (14.0%) a probable, 11 (11.8%) a possible and 26 (28.0%) no diagnosis of TIA. The median time from symptom onset to the visit to the TIA service was 114.5 (IQR 44.0-316.6) hours. Median patient delay was 17.5 (IQR 0.8-66.4) hours, with a delay of more than 24 hours in 36 (38.7%) patients. The GP was first contacted in 76 (81.7%) patients, and median time from first conta...Continue Reading

References

Jun 10, 2006·Stroke; a Journal of Cerebral Circulation·Michael D Hill, Nicolas U Weir
Oct 12, 2007·Lancet·Peter M RothwellUNKNOWN Early use of Existing Preventive Strategies for Stroke (EXPRESS) study
Mar 11, 2009·Journal of Neurology, Neurosurgery, and Psychiatry·N SpriggT G Robinson
Apr 17, 2010·Stroke; a Journal of Cerebral Circulation·Arvind ChandrathevaUNKNOWN Oxford Vascular Study
Jun 8, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jeffrey J PerryIan G Stiell
Apr 4, 2017·Clinical Medicine : Journal of the Royal College of Physicians of London·Anthony George RuddMartin A James

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