Patient delay in TIA: a systematic review

Journal of Neurology
L Servaas DolmansFrans H Rutten

Abstract

Patients who suffer a transient ischemic attack (TIA) have a high short-term risk of developing ischemic stroke, notably within the first 48 h. Timely diagnosis and urgent preventive treatment substantially reduce this risk. We conducted a systemic review to quantify patient delay in patients with (suspected) TIA, and assess determinants related to such delay. A systematic review using MEDLINE and EMBASE databases up to March 2017 to identify studies reporting the time from onset of TIA symptoms to seeking medical help. We identified nine studies providing data on patient delay, published between 2006 and 2016, with 7/9 studies originating from the United Kingdom (UK). In total 1103 time-defined TIA patients (no remaining symptoms > 24 h), and 896 patients with a minor stroke (i.e., mild remaining symptoms > 24 h) were included (49.1% men, mean age 72.2 years). Patient's delay of more than 24 h was reported in 33.1-44.4% of TIA patients, with comparable proportions for minor stroke patients. Delays were on average shorter in patients interviewed at the emergency department than among patients seen at TIA outpatient clinics. Univariably associated with a shorter delay were (1) a longer duration of symptoms, (2) motor symptoms, (...Continue Reading

References

Oct 12, 2007·Lancet·Peter M RothwellUNKNOWN Early use of Existing Preventive Strategies for Stroke (EXPRESS) study
Oct 12, 2007·Lancet Neurology·Philippa C LavalléePierre Amarenco
Nov 13, 2007·Lancet Neurology·Matthew F Giles, Peter M Rothwell
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Apr 17, 2010·Stroke; a Journal of Cerebral Circulation·Arvind ChandrathevaUNKNOWN Oxford Vascular Study
Sep 29, 2011·Clinical Neurology and Neurosurgery·Daniel GeffnerDavid Rodríguez
Aug 14, 2012·Emergency Medicine Journal : EMJ·Kashif Waqar FaizOle Morten Rønning

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