Differences in Clinical Characteristics between Patients with Transient Ischemic Attack Whose Symptoms Do and Do Not Persist on Arrival

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• 作者：Koji Tanaka ; MD^* ; Toshiyuki Uehara ; MD^* ; ^{tuehara@ncvc.go.jp" class="auth_mail" title="E-mail the corresponding author} ; Kazumi Kimura ; MD^&dagger ; ; Yasushi Okada ; MD^&Dagger ; ; Yasuhiro Hasegawa ; MD^§ ; ; Norio Tanahashi ; MD^‖ ; Akifumi Suzuki ; MD^¶ ; ; Shigeharu Takagi ; MD^# ; Jyoji Nakagawara ; MD^** ; Kazumasa Arii ; MD^&dagger ; &dagger ; ; Shinji Nagahiro ; MD^&Dagger ; &Dagger ; ; Kuniaki Ogasawara ; MD^§ ; § ; ; Takehiko Nagao ; MD^‖‖ ; Shinichiro Uchiyama ; MD^‖‖ ; Masayasu Matsumoto ; MD^¶ ; ¶ ; ; Koji Iihara ; MD^## ; Kazunori Toyoda ; MD^* ; Kazuo Minematsu ; MD^* ; on behalf of the Japan TIA Research Group ; 2009-2011
• 关键词：Transient ischemic attack ; ABCD2 score ; risk factor ; ischemic stroke ; persisting symptom
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：25
• 期：9
• 页码：2237-2242
• 全文大小：246 K

文摘

Symptoms of transient ischemic attack (TIA) persist on arrival and subsequently resolve in some patients admitted to hospitals early after onset. Differences in clinical characteristics between patients with acute TIA whose symptoms do and do not persist on arrival remain unclear.

Methods

We retrospectively extracted data of consecutive TIA patients with an onset-to-door time (ODT) of 24 hours or less and without a history of stroke from a multicenter TIA database. Clinical characteristics were compared between patients with and without persisting symptoms on arrival.

Results

Two hundred sixty-six patients (158 men, 68.0 ± 12.9 years) were included. Of the total number of patients, 105 (39.5%) had persisting symptoms with a mean National Institutes of Health Stroke Scale score of 2.4 (median, 1.0). Patients with persisting symptoms were more likely to have sensory disorder, ambulance-transported admission, long-duration TIA (≥60 minutes), and shorter ODT than those without. Multivariate analysis showed that sensory disorder (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.35-4.77), ambulance-transported admission (OR 1.80, 95% CI 1.00-3.28), and long-duration TIA (OR 3.96, 95% CI 2.12-7.71) were positively associated and that an ODT of more than 12 hours (OR .18, 95% CI .04-.63) was inversely associated with the presence ofpersisting symptoms. Patients with persisting symptoms were more likely to be examined by a stroke physician at first (69% versus 57%, P = .049) and then hospitalized in a stroke unit (59% versus 43%, P = .010).

Conclusion

Clinical manifestations and management after admission might differ between patients with acute TIA whose symptoms do and do not persist on arrival.