Incomplete ED Neurovascular Imaging Tied to Higher Odds of 90-Day Stroke

TUESDAY, June 13, 2023 (HealthDay News) — Emergency department visits for transient ischemic attack (TIA) with incomplete neurovascular imaging are associated with higher odds of subsequent stroke within 90 days, according to a study published online May 31 in the American Journal of Roentgenology.

Vincent M. Timpone, M.D., from the University of Colorado Hospital in Aurora, and colleagues evaluated the association between incomplete neurovascular imaging workup during emergency department encounters for TIA and odds of subsequent stroke. Analysis included 111,417 patients with a TIA diagnosis who underwent brain computed tomography or brain magnetic resonance imaging during or within two days of the encounter identified through the Medicare Standard Analytical Files for calendar years 2016 and 2017.

The researchers found that 37.3 percent of patients had an incomplete neurovascular imaging workup. Within 90 days of the TIA encounter, a new stroke diagnosis occurred in 4.4 percent of patients with complete neurovascular imaging versus 7.0 percent of patients with incomplete neurovascular imaging. When adjusting for patient (age, sex, race and ethnicity, high-risk comorbidities, median county household income) and hospital (region, rurality, number of beds, major teaching hospital designation) characteristics, incomplete neurovascular imaging was associated with increased likelihood of stroke within 90 days (odds ratio, 1.3).

“Increased access to urgent neurovascular imaging in patients with TIA may represent a target that could facilitate detection and treatment of modifiable stroke risk factors,” the authors write.

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