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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Impact of Hospital Admission for Patients with Transient Ischemic Attack
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Impact of Hospital Admission for Patients with Transient Ischemic Attack

机译：病态缺血症患者的医院入院的影响

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Objectives: To determine the impact of admission among transient ischemic attack (TIA) patients in the emergency department (ED). Study Design: Retrospective cohort study using national Veterans Health Administration data (2008). Methods: We first analyzed whether admitted patients were discharged from the hospital with a diagnosis of TIA. We then analyzed whether admission was associated with a composite outcome (new stroke, new myocardial infarction, or death in the year after TIA) using multivariate logistic regression modeling with propensity score matching. Results: Among 3623 patients assigned a diagnosis of TIA in the ED, 2118 (58%) were admitted to the hospital or placed in observation compared with 1505 (42%) who were discharged from the ED. Among the 2118 patients who were admitted, 903 (43% of admitted group) were discharged from the hospital with a diagnosis of TIA, and 548 (26% of admitted group) were discharged with a diagnosis of stroke. Admitted patients were more likely than nonadmitted patients to receive processes of care (i.e., brain imaging, carotid imaging, echocardiography). In matched analyses using propensity scores, the 1-year composite outcome in the admitted group (15.3%) was not lower than the discharged group (13.3%, OR 1.17 [.94-1.46], P = .17). Conclusions: Less than half of patients admitted with a diagnosis of TIA retained that diagnosis at hospital discharge. Although admitted patients were more likely to receive diagnostic procedures, we did not identify improvements in outcomes among admitted patients; however, evaluating care for patients with TIA is limited by the reliability of secondary data analysis.
机译：目标：确定急诊部（ED）中瞬态缺血症（TIA）患者的入学影响。研究设计：利用国家退伍军人卫生管理数据的回顾性队列研究（2008）。方法：首先分析是否入院患者从医院排出，诊断为TIA。然后，我们使用多元逻辑回归建模与倾向分数匹配的多元逻辑回归建模，分析是否与复合结果（在TIA之后的新中风，新的心肌梗死或死亡中有关。结果：3623名患者中，ED中的TIA诊断，2118（58％）被入院或置于观察中，而从ED中排出的1505（42％）。在入院的2118名患者中，903名（允许的小组的43％）从医院出院，诊断为TIA，548名（禁用组的26％）被排放，诊断中风。录取的患者比非分娩患者更容易接受护理过程（即脑成像，颈动脉成像，超声心动图）。在使用倾向评分的匹配分析中，录取的组（15.3％）的1年复合结果不低于排出基团（13.3％，或1.17 [94-1.46]，p = .17）。结论：不到一半的患者患有诊断TIA的诊断保留了医院排放的诊断。虽然被录取的患者更有可能接受诊断程序，但我们没有确定入院患者中的结果的改进;然而，评估TIA患者的护理受次级数据分析的可靠性的限制。

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