National survey of management of transient ischaemic attack in Australia : take immediate action

C.J. Price, David Blacker, R.S. Grimley, H.M. Dewey, R.P. Gerraty, S.A. Koblar, S.M. Denisenko, C.E. Storey, C.F. Bladin, K.M. Hill

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    Abstract

    Objective:To understand the current organisation of services for people with transient ischaemic attack (TIA) and the processes of assessment and management across Australian hospitals.Design and setting:Cross-sectional survey in 2008 of 134 Australian hospitals, mostly urban centres that treat large numbers of stroke patients.Main outcome measures:Survey questions covered assessment, early management and follow-up practices, as well as organisation of services for TIA.Results:Seventy-four hospitals (55%) responded: 47 (64%) reported access to a stroke unit, and 19 (26%) to a specialist clinic for TIA. Initial assessment included blood tests, electrocardiogram and brain computed tomography at most sites (92%–94%), and carotid imaging at more than half (65%), but magnetic resonance imaging at only 3% of sites. A tool to stratify the risk of subsequent stroke was used at 38 sites (51%), more commonly in hospitals with a stroke unit than in those without such a unit (64% v 30%; P = 0.005). Treatment was initiated at the initial assessment at 42 sites (58%), more commonly at stroke unit than non-stroke unit sites (68% v 37%; P = 0.007). Formalised policies for management of TIA patients were used at 38 sites (54%), with clear differences between sites with a stroke unit and those without (70% v 25%; P <0.001).Conclusion:Access to rapid assessment and management services for TIA varies considerably between Australian hospitals. The presence of organised stroke care at a hospital leads to improved processes of care for patients presenting with TIA.
    Original languageEnglish
    Pages (from-to)17-20
    JournalThe Medical journal of Australia
    Volume191
    Publication statusPublished - 2009

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    Price, C. J., Blacker, D., Grimley, R. S., Dewey, H. M., Gerraty, R. P., Koblar, S. A., Denisenko, S. M., Storey, C. E., Bladin, C. F., & Hill, K. M. (2009). National survey of management of transient ischaemic attack in Australia : take immediate action. The Medical journal of Australia, 191, 17-20. http://www.mja.com.au