Abstract
Background
The estimates of patients who present with transient ischemic attacks (TIA) in the
emergency departments (EDs) of United States and their disposition and factors that
determine hospital admission are not well understood.
Objective
We used a nationally representative database to determine the rate and predictors
of admission in TIA patients presenting to EDs.
Methods
We analyzed data from the National Emergency Department Sample (2006-2008) for all
patients presenting with a primary diagnosis of TIA in the United States. Samples
were weighted to provide national estimates of TIA hospitalizations and identify factors
that increase the odds of hospital admission including age, sex, type of insurance,
median household income, and hospital type (urban teaching, urban nonteaching, and
nonurban). Multivariate logistic regression analysis was used to identify independent
predictors of hospital admission.
Results
There were 812908 ED visits for primary diagnosis of TIA; mean age (±SD), 70.3 ± 14.9 years; and 57.9% were women from 2006 to 2008. Of these ED visits,
516837 (63.5%) were admitted to the hospital, whereas 296071 (36.5%) were discharged from the ED to home. In the multivariate logistic regression
analysis adjusting age, sex, and medical comorbidities, independent factors associated
with hospital admissions were median household income $64000 or higher (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.22-1.44; P = .003), Medicare insurance type (OR, 1.19; 95% CI, 1.14-1.26; P < .0001), and metropolitan teaching hospital ED (OR, 2.17; 95% CI, 1.90-2.48; P < .0001).
Conclusion
From 2006 to 2008, approximately 64% of all patients presenting with TIAs to the EDs
within United States were admitted to the hospital. Factors unrelated to patients'
condition such as median household income, insurance status, and ED affiliated hospital
type play an important role in the decision to admit TIA patients to the hospitals.
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Article Info
Publication History
Published online: February 04, 2013
Accepted:
October 2,
2012
Received in revised form:
September 30,
2012
Received:
May 26,
2012
Footnotes
☆All authors have read and approved submission of the manuscript.
☆☆The material in the manuscript has not been published and is not being considered for publication elsewhere in whole or in part in any language except as an abstract.
★Dr Qureshi has received funding from the National Institutes of Health RO1-NS44976-01A2 (medication provided by ESP Parma), American Heart Association Established Investigator Award 0840053N, National Institutes of Health U01-NS062091-01A2.
★★Contribution of authors: All authors have equally assisted in the synthesis and discussion of ideas, interpretation of data, and endovascular procedures. The majority of research, data collection, and writing of the manuscript were performed by these authors. Each person shared equal responsibility for the information written in the manuscript above.
Identification
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© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
