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Early Management of Transient Ischemic Attack in Emergency Departments in France

Abstract : Introduction:Emergency departments play a key role in the diagnosis and treatmentof transient ischemic attacks, but limited data are available about the early manage-ment of such patients in emergency wards. Therefore, we aimed to evaluate emer-gency physicians’management of transient ischemic attack and analyze variationsfactors.Methods:A multicenter survey among emergency physicians of the GrandEst region network (Est-RESCUE) was conducted from January 28th to March 28th,2019. Medical and administrative data were collected by the same network and thenational directory of medical resources.Results:Among 542 emergency physiciansrecipients, 78 answered (14%) and 71 werefinally included, practicing in 25 publichospitals homogeneously distributed across the territory, including 3 universityhospitals. A cerebral magnetic resonance imaging was obtained for 75%-100% ofpatients by 4.3% of responders, 36.4% of which were performed within more than24 hours. A cardiac monitoring was prescribed in 75%-100% of cases by 32.4% ofresponders. A neurologic consultation was routinely requested by 84.6% of res-ponders practicing in a university hospital and 36.8% of responders practicing in acommunity hospital (P= .02). Patients were hospitalized in a neurovascular unit in75%-100% of cases by 17.4% of responders, which happened more likely in univer-sity hospitals (P<.001).Conclusions:Transient ischemic attack suffers from man-agement disparities across territories, due to limited access to technical facilitiesand neurologic consultations. Therefore, international recommendations are toooften not followed. Implementation of territorial neurovascular tracks may help tostandardize the management of these patients.
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https://hal.univ-reims.fr/hal-03269834
Contributor : Valerian Dormoy <>
Submitted on : Thursday, June 24, 2021 - 12:24:33 PM
Last modification on : Thursday, June 24, 2021 - 12:34:55 PM

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Julie Gennesseaux, Guillaume Giordano Orsini, Sophie Lefour, Serge Bakchine, Quentin Marion, et al.. Early Management of Transient Ischemic Attack in Emergency Departments in France. Journal of Stroke and Cerebrovascular Diseases, WB Saunders, 2020, 29 (1), pp.104464. ⟨10.1016/j.jstrokecerebrovasdis.2019.104464⟩. ⟨hal-03269834⟩

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