Transiente ischämische Attacke (TIA) – ein Notfall!

Slezak, Agnieszka Anna; Arnold, Marcel; Galimanis, Aekaterini; Meli, Damian; Mattle, Heinrich; Mordasini, Pasquale; Bassetti, Claudio; Gralla, Jan; Liesirova, Kai Timo; Fischer, Urs

doi:10.4414/smf.2014.01903

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“…Le risque de souffrir d'un infarctus cérébral grave suite à un accident ischémique transitoire (AIT) est de 10-20% dans un délai de 90 jours, tandis que le risque de récidive dans les premières 24-48 h s'élève déjà à 4-7% [1,2].…”

Section: Introductionunclassified

Mise au point et traitement de l’accident vasculaire cérébral

Bühler¹,

Cina²

2017

Prim Hosp Care (fr)

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Section: Introductionunclassified

Mise au point et traitement de l’accident vasculaire cérébral

Bühler¹,

Cina²

2017

Prim Hosp Care (fr)

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“…Earlier surveys showed that primary care physicians found it hard to diagnose and manage TIAs, and that they treated TIA patients less urgently than stroke victims [ 6 – 10 ]; almost all of these studies were based on small samples. Recently, GPs and neurologists were the target of several articles in Swiss medical journals that described how to manage patients with TIAs [ 11 ][ 12 ][ 13 ] and the problem of estimating risk after TIA was commonly discussed at local, national and international conferences. However, these measures may not have effectively alerted GPs to stroke risk after TIA, and their willingness to refer TIA patients for emergency evaluation has not yet been assessed.…”

Section: Introductionmentioning

confidence: 99%

Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians

et al. 2015

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BackgroundTransient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates.MethodsWe used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient’s risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients.ResultsOf the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations “very often”. Physicians most commonly gave these reasons for not making emergency referrals: patient’s advanced age; patient’s preference; patient was multimorbid; and, patient needed long-term care.ConclusionsAlthough physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

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Transiente ischämische Attacke (TIA) – ein Notfall!

Cited by 2 publications

References 0 publications

Mise au point et traitement de l’accident vasculaire cérébral

Mise au point et traitement de l’accident vasculaire cérébral

Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians

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