engleski

EFFECT OF THE COMBINATION OF PUBLIC EDUCATION AND SERVICE REORGANISATION ON THE EMERGANT MANAGEMENT OF TRANSIENT ISCHEMIC ATTACK (TIA) AND MINOR STROKE

Background: As the result of public campaigns focused on the awareness of the stroke, published recommendations for stroke management and reorganisation of services, improvement outcome of TIA patients was observed. The aim was to validate the measures that improved management of patients with cerebral ischemic symptoms. Methods: One year data of 5219 patients examined in emergent neurological outpatient department were analyzed. Patients were referred from general practitioner, emergency physician or were brought by relatives without being previously seen by a health service. The service is organized to improve care for TIA patients, providing a short and standardized clinical assessment followed by initiation of a comprehensive stroke prevention program. Demographic data, risk factors, stroke type, preceding TIA, ABCD2 score and admittance rate are analyzed. Results: Between 1th January and 31th December 2008, 1057 patients suspected to have stroke or TIA were examined. There were: 447 ischemic strokes, 99 TIA, 56parenchymal hemorrhages, 49 subarachnoid hemorrhages and 406 patients with nonspecific symptoms, other systemic or neurological illness. Out of 447 ischemic strokes (73+11 years) 196 were males. TIA preceded stroke in 29 patients (6, 5%), and 197 (44%) patients were examined after worsening of stroke syndromes (133 within 24 hours, 47 within 48 hours, and 17 within 7 days). Out of 100 TIA (67+14 years) patients 55 were males. Mean ABCD2 score was 2, 95. In all patients comprehensive stroke prevention program was started, 427/447 (95%) strokes and 31/99 (31%) TIA's were hospitalized in Neurology clinic. Four TIA patients developed stroke (4%) and were hospitalized, 3 patients after 2 days (ABCD2 score 3, 4 and 5), and one after 7 days (ABCD2 score 5). Conclusion: Preventive measures resulted in a low number or strokes after TIA (<7%), but a relative high percentage (44%) of stroke patients ignored initial symptoms and seek medical attention after persistence or worsening of the symptoms.

TIA ; stroke ; emergency room ; prevention ; education

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