Mohamed Al-Khaled, Haneen Awwad, Christine Matthis and Toralf Brüning
Background and Purpose: Transient ischemic attack (TIA) is associated with a high short-term risk of stroke.
The aim of this study is to compare the diagnostic evaluation, therapeutic procedures, and secondary prevention
strategies in TIA patients who were directly admitted to a stroke unit (SU) and received semi-intensive care in
comparison to those who were treated in general wards (GW) in a mono-center study.
Methods: During a 6-year period (2008-2013), 1114 TIA patients who were admitted to the Department of
Neurology at the University of Schleswig-Holstein, campus Lübeck, were evaluated in a mono-center study.
Results: A total of 604 (57%) TIA patients were admitted to the SU, whereas 453(37%) patients were admitted to
the GW. Patients with a TIA who were undergoing treatment in an SU were significantly younger (69.1 vs. 71.0
years; P=0.023) and had higher rates of paresis (30.1 vs. 21.8%; p<0.003), hypertension (79.7 vs. 74.3%; P=0.042)
and hypercholesterolemia (57.2 vs. 46.7%; P=0.001) than those who were undergoing treatment in the GW. Patients
in SUs received significantly higher rates of carotid revascularization for symptomatic carotid stenosis (5.8% vs.
0.4%; P<0.001), dysphagia screening (47.6 vs. 27.3%; P<0.001), speech therapy (33.0 vs. 14.8%; P<0.001), and
physiotherapy (51.0 vs. 37.2%; P<0.001) in comparison to those admitted to GWs. The TIA etiology;
cardioembolism was significantly more common (18.0 vs. 12.7%; P=0.037) in patients treated in stroke unit,
whereas the undetermined etiology of TIA was significantly less diagnosed in patients who were admitted to SI-SU
than those treated in CC (50. vs. 58%; P=0.037). Carotid revascularization for symptomatic stenosis was more
performed in patients who underwent stroke unit care than those who were treated in general wards (5.8 vs. 0.4%,
P<0.001).
Conclusion: TIA-Treatment in the SU appears to be correlated with more diagnostic and therapeutic procedures
in comparison to care in general wards.