Transient ischemic attacks are more than "ministrokes"

• Verfasst von: Daffertshofer, Michael [VerfasserIn]
• Verfasst von: Mielke, Orell [VerfasserIn]
• Verfasst von: Pullwitt, Arne [VerfasserIn]
• Verfasst von: Felsenstein, Matthias [VerfasserIn]
• Verfasst von: Hennerici, Michael G. [VerfasserIn]
• Titel: Transient ischemic attacks are more than "ministrokes"
• Verf.angabe: Michael Daffertshofer, Orell Mielke, Arne Pullwitt, Matthias Felsenstein, and Michael Hennerici
• E-Jahr: 2004
• Jahr: 14 October 2004
• Umfang: 6 S.
• Fussnoten: Gesehen am 19.05.2022
• Titel Quelle: Enthalten in: Stroke
• Ort Quelle: New York, NY : Association, 1970
• Jahr Quelle: 2004
• Band/Heft Quelle: 35(2004), 11, Seite 2453-2458
• ISSN Quelle: 1524-4628
• DOI: doi:10.1161/01.STR.0000144050.90132.8e
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Activities of Daily Living
• Sach-SW: Female
• Sach-SW: Hospitalization
• Sach-SW: Humans
• Sach-SW: Ischemic Attack, Transient
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Outcome Assessment, Health Care
• Sach-SW: Prognosis
• Sach-SW: Prospective Studies
• Sach-SW: Risk
• Sach-SW: Stroke
• K10plus-PPN: 1802599401

Abstract

BACKGROUND AND PURPOSE: Transient ischemic attacks (TIAs) are warning signs of stroke. Recently, the hypothesis was raised that TIA bears a significant risk for death and dependence and requires the same complex diagnostic workup as a complete stroke. - METHODS: We prospectively collected pre- and in-hospital procedures, symptoms, outcome, complications, and therapies from a representative sample of all stroke-treating hospitals (n=82) in southwest Germany. Follow-up was attempted 6 months after discharge. End points were death or dependence in activities of daily living (Barthel Index <95, modified Rankin Scale (mRS) of 3 to 6, or institutionalization in a nursing home). - RESULTS: 1380 TIA patients and 3855 stroke patients entered the database. During hospital stay, stroke incidence was 8% for TIA patients and another 5% within the first half-year. Similarly, for ischemic stroke (IS) patients these figures were 7% and 6% (P>0.05), respectively. Two percent of TIA patients died in hospital (5% afterward) compared with 9% of stroke patients (10% afterward, P<0.001). Seventeen percent TIA compared with 38% IS patients (P<0.05) were dependent at follow-up. Whereas an estimated preexisting deficit (mRS >2) was the strongest predictor for death or disability (baseline mRS odds ratio, 4.1; 95% CI, 2.3 to 7.2), admission to a stroke unit was a valid predictor for survival and independence (odds ratio, 0.4; 95% CI, 0.2 to 0.9). - CONCLUSIONS: These data from a large, multicenter, nonselected, observational study underscore the "not so benign" prognosis for TIA patients. There is a relevant individual risk of early stroke, death, or disability in TIA patients. Management and treatment strategies are similar for both TIA and acute stroke.