التفاصيل البيبلوغرافية
| العنوان: |
Enhancing stroke risk prediction in patients with transient ischemic attack: insights from a prospective cohort study implementing fast-track care. |
| المؤلفون: |
Barone, Valentina, Foschi, Matteo, Pavolucci, Lucia, Rondelli, Francesca, Rinaldi, Rita, Nicodemo, Marianna, D’Angelo, Roberto, Favaretto, Elisabetta, Brusi, Carlotta, Cosmi, Benilde, Esposti, Daniela Degli, D’Addato, Sergio, Bacchelli, Stefano, Giostra, Fabrizio, Pomata, Daniela Paola, Spinardi, Luca, Faccioli, Luca, Faggioli, Gianluca, Donti, Andrea, Borghi, Claudio |
| المصدر: |
Frontiers in Neurology; 2024, p1-10, 10p |
| مصطلحات موضوعية: |
TRANSIENT ischemic attack, STROKE, STROKE units, LONGITUDINAL method, POISSON regression, COHORT analysis |
| مصطلحات جغرافية: |
NORTHERN Italy |
| مستخلص: |
Background and aims: Fast-track care have been proved to reduce the shortterm risk of stroke after transient ischemic attack (TIA). We aimed to investigate stroke risk and to characterize short- and long-term stroke predictors in a large cohort of TIA patients undergoing fast-track management. Methods: Prospective study, enrolling consecutive TIA patients admitted to a Northern Italy emergency department from August 2010 to December 2017. All patients underwent fast-track care within 24 h of admission. The primary outcome was defined as the first stroke recurrence at 90 days, 12 and 60 months after TIA. Stroke incidence with 95% confidence interval (CI) at each timepoint was calculated using Poisson regression. Predictors of stroke recurrence were evaluated with Cox regression analysis. The number needed to treat (NNT) of fast-track care in preventing 90-day stroke recurrence in respect to the estimates based on baseline ABCD2 score was also calculated. Results: We enrolled 1,035 patients (54.2% males). Stroke incidence was low throughout the follow-up with rates of 2.2% [95% CI 1.4–3.3%] at 90 days, 2.9% [95% CI 1.9–4.2%] at 12 months and 7.1% [95% CI 5.4–9.0%] at 60 months. Multiple TIA, speech disturbances and presence of ischemic lesion at neuroimaging predicted stroke recurrence at each timepoint. Male sex and increasing age predicted 90-day and 60-month stroke risk, respectively. Hypertension was associated with higher 12-month and 60-month stroke risk. No specific TIA etiology predicted higher stroke risk throughout the followup. The NNT for fast-track care in preventing 90-day stroke was 14.5 [95% CI 11.3–20.4] in the overall cohort and 6.8 [95% CI 4.6–13.5] in patients with baseline ABCD2 of 6 to 7. Conclusion: Our findings support the effectiveness of fast-track care in preventing both short- and long-term stroke recurrence after TIA. Particular effort should be made to identify and monitor patients with baseline predictors of higher stroke risk, which may vary according to follow-up duration. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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