The prognostic impact of the stroke unit care versus conventional care in treatment of patients with transient ischemic attack: A prospective population-based German study

Abstract

BACKGROUND AND PURPOSE: The risk of a stroke after a transient ischemic attack (TIA) is high in the short time following a TIA. The German Stroke Society recommends an early hospitalization of patients with TIA preferably in a stroke unit (SU). This study aims to compare the impact of SU care with conventional care (CC) in patients with TIA.

METHODS: In a prospective study, during a 36-month phase (starting November 2007), patients with TIA who were admitted to the hospital within 48 h of symptom onset were enrolled. Stroke rate during hospitalization and the 90-day rates of stroke and mortality were studied. Logistic regression analyses were used to estimate the odds ratio (OR).

RESULTS: Of 2,200 patients (mean age, 17.6 ± 12 years, 49% female), 1,347 (61%) treated in a SU and 853 (39%) received CC at general departments. Patients treated in SU were significantly younger than those received a CC (69.9 vs. 71.7 years; P = 0.001). TIA patients treated on SU received more ultrasound investigations of the neck arteries (98 vs. 96%; P = 0.003) and of the brain arteries (97 vs. 82%; P < 0.001) than those of CC. The primary outcomes (stroke during hospitalization, stroke after 90 days, and mortality after 90 days) did not show a difference between the SU and CC groups. In patients of male sex, the 90-day stroke rate was significantly lower in the SU group than the CC group (1.8 vs. 4.5%; P = 0.033). Using the adjusted logistic regression analysis, treatment in a SU revealed a reduction of 90-day stroke rate in patients of male sex (OR 0.38; 95% CI 0.15-0.95; P = 0.04).

CONCLUSION: The impact of evaluation and treatment of patients with TIA in SU and CC appears to differ only among patients of male sex. Further randomized trials are necessary.

Original languageEnglish
JournalJournal of vascular and interventional neurology
Volume5
Issue number2
Pages (from-to)22-6
Number of pages5
ISSN1941-5893
Publication statusPublished - 02.2013

Fingerprint

Dive into the research topics of 'The prognostic impact of the stroke unit care versus conventional care in treatment of patients with transient ischemic attack: A prospective population-based German study'. Together they form a unique fingerprint.

Cite this