Quality of referrals and guideline compliance for time to consultation at an acute neurovascular clinic

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Milton SalesParker Magin

Abstract

The Age, Blood pressure, Clinical features, Duration of symptoms, Diabetes (ABCD2) score can be used to predict early recurrent stroke risk following Transient ischemic attack (TIA). Given that recurrent stroke risk can be as high as 20% in the first week, international guidelines recommend "high-risk" TIAs (ABCD2 >3) be seen by specialist services such as dedicated acute neurovascular clinics within 24 hours. The goal of this study was to examine the associations of both quality of referrals to a specialist acute clinic and of "guideline congruence" of time-to-clinic consultation after TIA/minor stroke. We hypothesized high-quality referrals containing key clinical elements would be associated with greater guideline congruence. A retrospective analysis of referrals to an acute neurovascular clinic within a tertiary care hospital of consecutive patients with TIA/minor stroke. Quality of general practitioner and emergency department referrals was defined on the basis of information content enabling ABCD2-based risk stratification by the clinic triage service. Time-to-clinic consultation was used to define "guideline congruence." Referrals of 148 consecutive eligible patients were reviewed. Sixty-six percent of cases were subsequ...Continue Reading

References

Jul 23, 2002·Lancet·Graham Watt
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Jul 26, 2008·BMJ : British Medical Journal·Sharon SwainUNKNOWN Guideline Development Group
Mar 11, 2009·Journal of Neurology, Neurosurgery, and Psychiatry·N SpriggT G Robinson
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Nov 12, 2010·The Journal of School Nursing : the Official Publication of the National Association of School Nurses·Beverly Wilkinson
Mar 16, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Parker MaginChristopher Levi

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Citations

Jan 12, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Nashwa NajibChristopher Levi
Apr 14, 2017·Family Practice·Andrew R DaveyParker J Magin

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