Transient Ischemic Attack
Conditions
Keywords
Emergency, Cerebral RMI, Guidelines compliance
Brief summary
A transient ischemic attack (TIA) is a momentary neurological dysfunction due to a brief cessation of blood flow to a region of the brain, resulting in typical signs of stroke (hemiplegia, aphasia, dysarthria), but whose clinical symptoms typically last less than an hour, with no visible lesion on imaging. This diagnosis remains difficult and is essentially based on the clinical judgment of the physician. Because a TIA can be a pre-alarm for stroke in 20-30% of cases, it needs to be treated appropriately and as early as possible in the emergency department. Stroke rates after untreated TIA are 5% within 48 hours, 10% within one month and 20% within one year. This risk is calculated using the ABCD² score which is based on the patient's risk factors and the clinical manifestations of TIA. Patients with a score ≥ 3 should be hospitalized as soon as possible for a complete medical evaluation. However, this score has not been scientifically validated, and several specialists agree that all TIAs should be evaluated immediately. Preventing stroke is a major public health issue because it is a serious, disabling and sometimes fatal disease. Given the seriousness of the progression from TIA to stroke, the French National Authority for Health has issued a series of management recommendations. However, in practice, these guidelines remain complicated to follow and patients management may vary and be more or less effective. Therefore, the aim of this study is to highlight the differences in how inpatients and outpatients are managed. Following these observations, solutions will be sought to make the care and management of these patients more efficient and more in line with recommendations.
Interventions
BEHAVIORALSatisfaction questionnaire
Satisfaction questionnaire to assess how TIA patients feels about their medical care.
OTHERMedical care questionnaire
Recording appointments and results of examinations and consultations in TIA management
Sponsors
Centre Hospitalier Henri Duffaut - Avignon
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient over 18 years old. * Consultation in the emergency department. * Suspected TIA diagnosed by emergency physician. * Duration of TIA symptoms \<1 hour.
Exclusion criteria
* Validation MRI performed prior to suspected TIA. * Patient hospitalized for a condition other than TIA, including stroke. * Patient referred to another hospital for further examination. * Pregnant women. * Patient unable to understand and answer a questionnaire. * Patient under legal protection.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Assess time between arrival in the emergency department for suspected TIA patients and MRI. | Baseline |
Secondary
| Measure | Time frame |
|---|---|
| Time between arrival in the emergency department and MRI by departments. | Baseline |
| Time between arrival in the emergency department and MRI by ABCD² score. | Baseline |
| Percentage of patients with complete TIA management by departments. | Baseline |
| Hospitalization times according to care units | Baseline |
| Hospitalization times according to complete TIA management | Baseline |
| Percentage of patients with secondary event, according to complete TIA management | Baseline |
| Number of outpatients without complete TIA management one month after TIA. | At 1 month follow-up |
| Patient satisfaction with a short questionnaire | At 1 month follow-up |
Countries
France
Outcome results
None listed