Table 2.
Clinical characteristics of 7607 patients with transient ischaemic attack (TIA) admitted to the emergency department. Values are numbers (percentages) unless stated otherwise
| Characteristics | All patients (n=7607) | Low risk (n=1242) | Medium risk (n=5484) | High risk (n=881) |
|---|---|---|---|---|
| Demographics | ||||
| Mean (SD) age, years | 68.5 (14.7) | 65.3 (14.5) | 68.1 (14.8) | 75 (11.7) |
| Median (interquartile range) age, years | 70 (58-80) | 66 (54-77) | 69 (58-80) | 76 (68-84) |
| Age range, years | 18-103 | 18-98 | 18-103 | 36-99 |
| Female sex | 3982 (52.3) | 695 (56.0) | 2936 (53.5) | 351 (39.8) |
| Clinical features: history | ||||
| Arrival by ambulance | 2765/7605 (36.4) | 365/1242 (29.4) | 1962/5482 (35.8) | 438/881 (49.7) |
| First ever TIA | 5706/7589 (75.2) | 765/1237 (61.8) | 4208/5474 (76.9) | 733/878 (83.5) |
| Duration of symptoms: | (n=7543) | (n=1222) | (n=5445) | (n=876) |
| <1 minute | 221 (2.9) | 132 (10.8) | 86 (1.6) | 3 (0.3) |
| 1-4 minutes | 468 (6.2) | 232 (19.0) | 226 (4.2) | 10 (1.1) |
| 5-9 minutes | 486 (6.4) | 216 (17.7) | 247 (4.5) | 23 (2.6) |
| 10-29 minutes | 1383 (18.3) | 130 (10.6) | 1076 (19.8) | 177 (20.2) |
| 30-59 minutes | 1120 (14.8) | 126 (10.3) | 844 (15.5) | 150 (17.1) |
| ≥60 minutes | 3865 (51.2) | 386 (31.6) | 2966 (54.5) | 513 (58.6) |
| History of altered sensation | 3269/7521 (43.5) | 470/1231 (38.2) | 2465/5419 (45.5) | 334/871 (38.3) |
| History of weakness | 3019/7544 (40.0) | 273/1234 (22.1) | 2164/5435 (39.8) | 582/875 (66.5) |
| Language disturbance | 2943/7442 (39.5) | 327/1208 (27.1) | 2109/5370 (39.3) | 507/864 (58.7) |
| Light-headedness | 1297/7281 (17.8) | 302/1201 (25.1) | 871/5246 (16.6) | 124/834 (14.9) |
| Vertigo | 779/7338 (10.6) | 474/1222 (38.8) | 281/5278 (5.3) | 24/838 (2.9) |
| Gait disturbance | 1571/7356 (21.4) | 226/1203 (18.8) | 1027/5311 (19.3) | 318/842 (37.8) |
| Visual loss | 1069/7113 (15.0) | 254/1158 (21.9) | 740/5139 (14.4) | 75/816 (9.2) |
| Clinical features: examination | ||||
| Mean (SD) initial systolic blood pressure, mm Hg (n=7597) | 151.9 (26.1) | 150.6 (24.1) | 151.7 (25.7) | 155.4 (30.4) |
| Mean (SD) initial diastolic blood pressure, mm Hg (n=7594) | 82.9 (13.7) | 82.9 (11.8) | 82.7 (13.3) | 84.3 (18.3) |
| Mean (SD) initial heart rate, bpm (n=7600) | 77.6 (15.0) | 77.2 (14.2) | 77.7 (14.9) | 77.6 (16.3) |
| Weakness | 997/7547 (13.2) | 57/1234 (4.6) | 720/5440 (13.2) | 220/873 (25.2) |
| Altered sensation | 868/7489 (11.6) | 105/1229 (8.5) | 675/5395 (12.5) | 88/865 (10.2) |
| Any speech difficulty | 850/7523 (11.3) | 51/1226 (4.2) | 617/5421 (11.4) | 182/873 (20.8) |
| Gait abnormality | 617/7397 (8.3) | 105/1222 (8.6) | 383/5338 (7.2) | 129/837 (15.4) |
| Dysarthria | 564/7486 (7.5) | 30/1229 (2.4) | 397/5392 (7.4) | 137/868 (15.8) |
| Pronator drift | 405/7053 (5.7) | 33/1157 (2.9) | 278/5095 (5.5) | 94/801 (11.7) |
| Aphasia | 268/7486 (3.6) | 18/1226 (1.5) | 205/5392 (3.8) | 45/868 (5.2) |
| Abnormal finger-nose test | 262/7312 (3.6) | 30/1213 (2.5) | 182/5268 (3.5) | 50/831 (6.0) |
| Clinical features: past medical history | (n=7592) | (n=1238) | (n=5474) | (n=880) |
| Hypertension | 4505 (59.3) | 599 (48.4) | 3191 (58.3) | 715 (81.3) |
| High cholesterol | 2772 (36.5) | 379 (30.6) | 1973 (36.0) | 420 (47.7) |
| Diabetes mellitus | 1448 (19.1) | 138 (11.1) | ,002 (18.3) | 308 (35.0) |
| Coronary artery disease | 1289 (17.0) | 101 (8.2) | 866 (15.8) | 322 (36.6) |
| Known previous stroke | 976 (12.9) | 119 (9.6) | 672 (12.3) | 185 (21.0) |
| Current smoker | 840 (11.1) | 128 (10.3) | 616 (11.3) | 96 (10.9) |
| Atrial fibrillation | 806 (10.6) | 96 (7.8) | 535 (9.8) | 175 (19.9) |
| Peripheral vascular disease | 269 (3.5) | 17 (1.4) | 176 (3.2) | 76 (8.6) |
| Carotid stenosis | 251 (3.3) | 9 (0.7) | 138 (2.5) | 104 (11.8) |
| Diagnostic tests in emergency department | ||||
| Computed tomography of head | 7337 (96.5) | 1191 (95.9) | 5287 (96.4) | 859 (97.5) |
| Evidence of acute or old infarction | 2080 (27.3) | 172 (13.8) | 1413 (25.8) | 495 (56.2) |
| Electrocardiography | 6923 (91.0) | 1114 (89.7) | 4993 (91.0) | 816 (92.6) |
| Evidence of atrial fibrillation | 425 (5.6) | 22 (1.8) | 255 (4.7) | 148 (16.8) |
| Magnetic resonance imaging of head | 323 (4.2) | 37 (3.0) | 244 (4.4) | 42 (4.8) |
| Carotid Doppler | 4382 (57.6) | 684 (55.1) | 3225 (58.8) | 473 (53.7) |
| Computed tomography angiography of neck | 2085 (27.4) | 309 (24.9) | 1493 (27.2) | 283 (32.1) |
| Routine drugs at time of index TIA | ||||
| Antihypertensive | 3579 (47.0) | 461 (37.1) | 2522 (46.0) | 596 (67.7) |
| Any antithrombotic | 3274 (43.0) | 231 (18.6) | 2328 (42.5) | 715 (81.2) |
| Aspirin | 2274 (29.9) | 101 (8.1) | 1593 (29.0) | 580 (65.8) |
| Clopidogrel | 588 (7.7) | 31 (2.5) | 423 (7.7) | 134 (15.2) |
| Warfarin | 348 (4.6) | 66 (5.3) | 224 (4.1) | 58 (6.6) |
| Dipyridamole/aspirin | 55 (0.7) | 3 (0.2) | 41 (0.7) | 11 (1.2) |
| Ticlopidine | 6 (0.1) | 2 (0.2) | 3 (0.1) | 1 (0.1) |
| Other anticoagulant | 367 (4.8) | 49 (3.9) | 269 (4.9) | 49 (5.6) |
| Statin | 2772 (36.4) | 342 (27.5) | 1946 (35.5) | 484 (54.9) |
| Drugs on discharge | ||||
| Antihypertensive | 3728 (49.0) | 473 (38.1) | 2634 (48.0) | 621 (70.5) |
| Any antithrombotic | 6667 (87.6) | 1002 (80.7) | 4807 (87.7) | 858 (97.4) |
| Aspirin | 5477 (72.0) | 866 (69.7) | 3943 (71.9) | 668 (75.8) |
| Clopidogrel | 1251 (16.4) | 65 (5.2) | 898 (16.4) | 288 (32.7) |
| Warfarin | 362 (4.8) | 66 (5.3) | 233 (4.2) | 63 (7.2) |
| Dipyridamole/aspirin | 136 (1.8) | 8 (0.6) | 97 (1.8) | 31 (3.5) |
| Ticlopidine | 6 (0.1) | 2 (0.2) | 3 (0.1) | 1 (0.1) |
| Other anticoagulant | 413 (5.4) | 51 (4.1) | 296 (5.4) | 66 (7.5) |
| Statin | 3109 (40.9) | 401 (32.3) | 2195 (40.0) | 513 (58.2) |
| Primary outcome | ||||
| Stroke or carotid revascularisation ≤7 days | 183 (2.4) | 6 (0.5) | 124 (2.3) | 53 (6.0) |
| Secondary outcomes | ||||
| Carotid revascularisation ≤7 days from index visit | 84 (1.1) | 3 (0.2) | 52 (0.9) | 29 (3.3) |
| Carotid revascularisation ≤90 days from index visit | 156 (2.1) | 12 (1.0) | 95 (1.7) | 49 (5.6) |
| Carotid endarterectomy ≤7 days from index visit | 69 (0.9) | 3 (0.2) | 42 (0.8) | 24 (2.7) |
| Carotid endarterectomy ≤90 days from index visit | 130 (1.7) | 12 (1.0) | 80 (1.5) | 38 (4.3) |
| Carotid stent ≤7 days from index visit | 16 (0.2) | 0 (0) | 11 (0.2) | 5 (0.6) |
| Carotid stent ≤90 days from index visit | 29 (0.4) | 0 (0) | 17 (0.3) | 12 (1.4) |
| Cumulative stroke ≤2 days from index visit | 70 (0.9) | 1 (0.1) | 51 (0.9) | 18 (2.0) |
| Cumulative stroke ≤7 days from index visit | 108 (1.4) | 3 (0.2) | 81 (1.5) | 24 (2.7) |
| Cumulative stroke ≤30 days from index visit | 153 (2.0) | 4 (0.3) | 116 (2.1) | 33 (3.7) |
| Cumulative stroke ≤90 days from index visit | 192 (2.5) | 5 (0.4) | 141 (2.6) | 46 (5.2) |
| Cumulative recurrent TIA ≤2 days from index visit | 81 (1.1) | 5 (0.4) | 56 (1.0) | 20 (2.3) |
| Cumulative recurrent TIA ≤7 days from index visit | 154 (2.0) | 15 (1.2) | 108 (2.0) | 31 (3.5) |
| Cumulative recurrent TIA ≤30 days from index visit | 261 (3.4) | 30 (2.4) | 180 (3.3) | 51 (5.8) |
| Cumulative recurrent TIA ≤90 days from index visit | 357 (4.7) | 44 (3.5) | 244 (4.4) | 69 (7.8) |
| Myocardial infarction ≤90 days from index visit | 26 (0.3) | 2 (0.2) | 16 (0.3) | 8 (0.9) |
| Admitted to hospital during index visit | 441 (5.8) | 40 (3.2) | 298 (5.4) | 103 (11.7) |