The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events

ozyuncu, nil; TULUNAY KAYA, CANSIN; erdogan, seyda; TOGAY ISIKAY, CANAN; Kuru Oz, Digdem; peker, elif; YAVUZ, KIVILCIM; Erdoğan, Mustafa; Sorgun, Mine Hayriye; Ozaydin Aksun, Zerin; Arslan, Murat; Gursoy Coruh, Aysegul

doi:10.4274/tnd.2022.80932

The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events

Mine Hayriye SORGUN, (Ankara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Zerin ÖZAYDIN AKSUN, (Ankara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Seyda ERDOĞAN, (Ankara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Murat ARSLAN, (Ankara Üniversitesi, Tıp Fakültesi, Odyoloji Anabilim Dalı, Ankara, Türkiye)

Ayşegül GÜRSOY ÇORUH, (Ankara Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Ankara, Türkiye)

Diğdem KURU ÖZ, (Ankara Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Ankara, Türkiye)

Nil ÖZYÜNCÜ, (Ankara Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Elif PEKER, (Ankara Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Ankara, Türkiye)

Cansın TULUNAY KAYA, (Ankara Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Kıvılcım YAVUZ, (Ankara Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Ankara, Türkiye)

Mustafa ERDOĞAN, (Ankara Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Ankara, Türkiye)

Canan Togay IŞIKAY, (Ankara Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Diğer Yazarlar

Türk Nöroloji Dergisi

5 1

Yıl: 2023 Cilt: 29 Sayı: 1 Sayfa Aralığı: 18 - 23 Metin Dili: İngilizce DOI: 10.4274/tnd.2022.80932 İndeks Tarihi: 30-05-2023

The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events

Öz:

Objective: Identifying the etiology and early treatment following a transient ischemic attack (TIA) or minor stroke may prevent patients from having a disabling ischemic stroke. The primary aim of this study was to increase awareness of the symptoms of TIA and minor ischemic stroke and provide early intervention via a TIA unit. In addition, the benefits provided by the TIA unit were analyzed in terms of prognosis and length of hospital stay. Materials and Methods: Before beginning the study, brochures and posters containing information about the symptoms of a TIA and minor ischemic stroke, along with the mobile phone number of a research fellow, were distributed in the clinics and hung on the main boards of the Ankara University Faculty of Medicine Hospitals. A presentation on the TIA unit was also given to the healthcare professionals of the hospitals. Afterward, 69 patients consecutively admitted with symptoms of a TIA or minor ischemic stroke [with a National Institutes of Health Stroke Scale (NIHSS) score of ≤5] between September 16, 2019, and September 15, 2020, were prospectively included in the study group. The hospital charts of 90 consecutive patients admitted with a TIA or minor ischemic stroke (with an NIHSS score of ≤5) were retrospectively evaluated as the control group from September 16, 2018, to September 15, 2019. The timing of the etiological diagnoses and treatments, the length of the hospital stay, and the prognoses of these two groups of patients, one comprising patients admitted before and the other comprising patients admitted after the TIA unit was established, were compared. Results: The two groups had no significant difference in vascular events and mortality. However, in the logistic regression analysis, the length of the hospital stay was significantly shorter in the study group (P = 0.015). Conclusion: A TIA and a minor stroke should be recognized quickly, and diagnostic tests should be performed as soon as possible to shorten the period of the hospital stay and reduce the costs and complications related to longer hospitalization.

Anahtar Kelime:

Geçici İskemik Atak Ünitesinin İnme ve Diğer Vasküler Olayların Erken Tanı ve Tedavisi Üzerine Etkileri

Öz:

Amaç: Geçici iskemik atak (GİA) ve minör inme sonrasında etiyolojik nedenin hızlıca bulunması ve uygun tedavinin başlanması hastaların özürlülük yaratacak şiddette iskemik inme geçirmesini önleyebilir. Bu çalışmanın primer amacı GİA ve minör inmenin farkındalığını artırmak ve GİA ünitelerine erken başvuruyu sağlamaktır. Ayrıca GİA ünitesinin, prognoz ve hastanede kalış sürelerine sağladığı faydayı araştırmaktır. Gereç ve Yöntem: Çalışmaya başlamadan önce, kliniklere GİA ve minör inme belirtileri hakkında bilgi veren ve hastaların ulaşabilmesi için araştırma görevlisinin telefon numarası bulunan broşürler dağıtılmıştır, posterler asılmıştır ve Ankara Üniversitesi Tıp Fakültesi Hastaneleri sağlık çalışanlarına GİA ünitesinin tanıtımı yapılmıştır. Daha sonra 16 Eylül 2019 - 15 Eylül 2020 arasında GİA veya minör iskemik inme semptomları (NIHSS ≤5) ile başvuran ardışık 69 hasta prospektif olarak çalışma grubuna dahil edilmiştir. 16 Eylül 2018 - 15 Eylül 2019 arasında GİA veya minör iskemik inme (NIHSS ≤5) ile başvurmuş ardışık 90 hastanın kayıtları kontrol grubu olarak retrospektif değerlendirilmiştir. GİA ünitesi öncesi ve sonrası başvuran iki grup hastanın etiyolojik tanı ve tedavi zamanlaması, hastanede kalış süresi ve prognoz açısından karşılaştırılmıştır. Bulgular: İki grup arasında vasküler olaylar ve vasküler mortalite açısından anlamlı bir fark bulunmamıştır. Yapılan lojistik regresyon analizinde, hastanede yatış süresi çalışma grubunda anlamlı olarak daha kısa tespit edilmiştir (P = 0,015). Sonuç: GİA ve minör inme hastaları hızlıca tanınmalı ve kalış süresini kısaltmak, hastane maliyetlerini ve olası komplikasyonları azaltmak için araştırma tetkikleri en kısa sürede yapılmalıdır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. A classification and outline of cerebrovascular diseases. II. Stroke 1975;6:564-616.
2. Feinberg WM, Albers GW, Barnett HJ, et al. Guidelines for the management of transient ischemic attacks. From the Ad Hoc Committee on Guidelines for the Management of Transient Ischemic Attacks of the Stroke Council of the American Heart Association. Circulation 1994;89:2950-2965.
3. Sorensen AG, Ay H. Transient ischemic attack: definition, diagnosis, and risk stratification. Neuroimaging Clin N Am 2011;21:303-313.
4. Tuna MA, Rothwell PM; Oxford Vascular Study. Diagnosis of non-consensus transient ischaemic attacks with focal, negative, and non-progressive symptoms: population-based validation by investigation and prognosis. Lancet 2021;397:902-912.
5. van Rooij FG, Vermeer SE, Góraj BM, et al. Diffusion-weighted imaging in transient neurological attacks. Ann Neurol 2015;78:1005-1010.
6. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000;284:2901-2906.
7. Coull AJ, Lovett JK, Rothwell PM; Oxford Vascular Study. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ 2004;328:326.
8. Rothwell PM, Warlow CP. Timing of TIAs preceding stroke: time window for prevention is very short. Neurology 2005;64:817-820.
9. Johnston SC, Rothwell PM, Nguyen-Huynh MN, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007;369:283-292.
10. Giles MF, Rothwell PM. Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol 2007;6:1063-1072.
11. Lavallée PC, Meseguer E, Abboud H, et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol 2007;6:953-960.
12. Kamal AK, Itrat A, Murtaza M, et al. The burden of stroke and transient ischemic attack in Pakistan: a community-based prevalence study. BMC Neurol 2009;9:58.
13. Al-Khaled M, Matthis C, Eggers J. The prognostic impact of the stroke unit care versus conventional care in treatment of patients with transient ischemic attack: a prospective population-based German study. J Vasc Interv Neurol 2013;5:22-26.
14. Corrao G, Rea F, Merlino L, et al. Management, prognosis and predictors of unfavourable outcomes in patients newly hospitalized for transient ischemic attack: a real-world investigation from Italy. BMC Neurol 2017;17:12.
15. Fischer U, Baumgartner A, Arnold M, et al. What is a minor stroke? Stroke 2010;41:661-666.
16. Song B, Fang H, Zhao L, et al. Validation of the ABCD3-I score to predict stroke risk after transient ischemic attack. Stroke 2013;44:1244-1248.
17. Ay H, Furie KL, Singhal A, et al. An evidence-based Causative Classification System for acute ischemic stroke. Ann Neurol 2005;58:688-697.
18. Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44:870-947.
19. Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/ American Stroke Association. Stroke 2018;49:e46-e110. Erratum in: Stroke 2018;49:e138.
20. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019;50:e344-e418.

APA	Sorgun M, Ozaydin Aksun Z, erdogan s, Arslan M, Gursoy Coruh A, Kuru Oz D, ozyuncu n, peker e, TULUNAY KAYA C, YAVUZ K, Erdoğan M, TOGAY ISIKAY C (2023). The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. , 18 - 23. 10.4274/tnd.2022.80932
Chicago	Sorgun Mine Hayriye,Ozaydin Aksun Zerin,erdogan seyda,Arslan Murat,Gursoy Coruh Aysegul,Kuru Oz Digdem,ozyuncu nil,peker elif,TULUNAY KAYA CANSIN,YAVUZ KIVILCIM,Erdoğan Mustafa,TOGAY ISIKAY CANAN The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. (2023): 18 - 23. 10.4274/tnd.2022.80932
MLA	Sorgun Mine Hayriye,Ozaydin Aksun Zerin,erdogan seyda,Arslan Murat,Gursoy Coruh Aysegul,Kuru Oz Digdem,ozyuncu nil,peker elif,TULUNAY KAYA CANSIN,YAVUZ KIVILCIM,Erdoğan Mustafa,TOGAY ISIKAY CANAN The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. , 2023, ss.18 - 23. 10.4274/tnd.2022.80932
AMA	Sorgun M,Ozaydin Aksun Z,erdogan s,Arslan M,Gursoy Coruh A,Kuru Oz D,ozyuncu n,peker e,TULUNAY KAYA C,YAVUZ K,Erdoğan M,TOGAY ISIKAY C The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. . 2023; 18 - 23. 10.4274/tnd.2022.80932
Vancouver	Sorgun M,Ozaydin Aksun Z,erdogan s,Arslan M,Gursoy Coruh A,Kuru Oz D,ozyuncu n,peker e,TULUNAY KAYA C,YAVUZ K,Erdoğan M,TOGAY ISIKAY C The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. . 2023; 18 - 23. 10.4274/tnd.2022.80932
IEEE	Sorgun M,Ozaydin Aksun Z,erdogan s,Arslan M,Gursoy Coruh A,Kuru Oz D,ozyuncu n,peker e,TULUNAY KAYA C,YAVUZ K,Erdoğan M,TOGAY ISIKAY C "The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events." , ss.18 - 23, 2023. 10.4274/tnd.2022.80932
ISNAD	Sorgun, Mine Hayriye vd. "The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events". (2023), 18-23. https://doi.org/10.4274/tnd.2022.80932

APA	Sorgun M, Ozaydin Aksun Z, erdogan s, Arslan M, Gursoy Coruh A, Kuru Oz D, ozyuncu n, peker e, TULUNAY KAYA C, YAVUZ K, Erdoğan M, TOGAY ISIKAY C (2023). The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. Türk Nöroloji Dergisi, 29(1), 18 - 23. 10.4274/tnd.2022.80932
Chicago	Sorgun Mine Hayriye,Ozaydin Aksun Zerin,erdogan seyda,Arslan Murat,Gursoy Coruh Aysegul,Kuru Oz Digdem,ozyuncu nil,peker elif,TULUNAY KAYA CANSIN,YAVUZ KIVILCIM,Erdoğan Mustafa,TOGAY ISIKAY CANAN The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. Türk Nöroloji Dergisi 29, no.1 (2023): 18 - 23. 10.4274/tnd.2022.80932
MLA	Sorgun Mine Hayriye,Ozaydin Aksun Zerin,erdogan seyda,Arslan Murat,Gursoy Coruh Aysegul,Kuru Oz Digdem,ozyuncu nil,peker elif,TULUNAY KAYA CANSIN,YAVUZ KIVILCIM,Erdoğan Mustafa,TOGAY ISIKAY CANAN The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. Türk Nöroloji Dergisi, vol.29, no.1, 2023, ss.18 - 23. 10.4274/tnd.2022.80932
AMA	Sorgun M,Ozaydin Aksun Z,erdogan s,Arslan M,Gursoy Coruh A,Kuru Oz D,ozyuncu n,peker e,TULUNAY KAYA C,YAVUZ K,Erdoğan M,TOGAY ISIKAY C The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. Türk Nöroloji Dergisi. 2023; 29(1): 18 - 23. 10.4274/tnd.2022.80932
Vancouver	Sorgun M,Ozaydin Aksun Z,erdogan s,Arslan M,Gursoy Coruh A,Kuru Oz D,ozyuncu n,peker e,TULUNAY KAYA C,YAVUZ K,Erdoğan M,TOGAY ISIKAY C The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events. Türk Nöroloji Dergisi. 2023; 29(1): 18 - 23. 10.4274/tnd.2022.80932
IEEE	Sorgun M,Ozaydin Aksun Z,erdogan s,Arslan M,Gursoy Coruh A,Kuru Oz D,ozyuncu n,peker e,TULUNAY KAYA C,YAVUZ K,Erdoğan M,TOGAY ISIKAY C "The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events." Türk Nöroloji Dergisi, 29, ss.18 - 23, 2023. 10.4274/tnd.2022.80932
ISNAD	Sorgun, Mine Hayriye vd. "The Effects of a “Transient Ischemic Attack Unit” on the Early Diagnosis and Treatment of Stroke and Other Vascular Events". Türk Nöroloji Dergisi 29/1 (2023), 18-23. https://doi.org/10.4274/tnd.2022.80932