TY - THES ID - 134754511 TI - Evaluation and outcome of triage for patients with transient ischemic attack A two-year analysis of the TIA Clinic of the University Hospitals Leuven AU - Vandenbussche, Nicolas AU - Lemmens, Robin. AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de specialistische geneeskunde (Leuven) PY - 2017 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:134754511 AB - Background: Urgent evaluation of transient ischemic attack (TIA) has shown to lower the risk of recurrent cerebrovascular events in multiple TIA clinic models. We present the results of our TIA clinic model in the first two years of practice. In addition, we compared our results with TIA patients with matching clinical profiles who were admitted in our hospital during 2013 and 2014. Methods: The TIA Clinic model was developed for triage and fast-track evaluation of TIA patients with neurological, imaging and vessel evaluation, with subsequent secondary cardiovascular preventive interventions. Only patients with ABCD2 score ≥ 4, carotid stenosis ≥ 50% or presence of diffusion weighted imaging (DWI) lesions were scored as high risk patients and admitted to hospital. We prospectively collected data on the rate of recurrence at 90 days, hospitalization rate, patient characteristics and patient assessment. Finally, we retrospectively collected corresponding data from TIA patients with similar profiles during 2013 and 2014 and compared the results with the TIA Clinic patients. Findings: The total risk of recurrence at 90 days for TIA Clinic patients was 3,6%, similar to 6,8% in the period 2013-2014 (p=0,70). None of the low-risk TIA clinic patients had a recurrent cerebrovascular event at 90 days follow up, compared to two patients in the high-risk group. The rate of hospital admissions was similar during TIA Clinic period compared to the 2013-2014 period (67,9% vs 72%; p=0,61). The TIA Clinic protocol resulted in faster access to MRI scans (p = 0,001), more usage of MRI brain scans (p=0,0017) and CT angiography (p = 0,0058), less CT whole brain scans (p < 0,001), more prescriptions of statin therapies at discharge (p < 0,0001) and more follow-up visits (p=0,0085) in comparison to the patients assessed in 2013 and 2014. Conclusions: The TIA Clinic model resulted in low rates of recurrent cerebrovascular event at 90 days after TIA and is a safe and efficacious model for management of low risk TIA patients in an outpatient setting. The TIA Clinic model improved patient assessment in comparison to the earlier approach towards TIA patients and resulted in equal percentage of recurrence at 90 days. ER -