More incompetence in the stroke world, you better hope you're in the 30% category. All because these are guidelines, NOT PROTOCOLS.
70% of ‘mini-stroke’ patients imaged incompletely, risking full-on stroke
Emergency patients diagnosed with transient ischemic attack are supposed to receive, per multiple society guidelines, a complete imaging workup as soon as possible—preferably within 48 hours of ED discharge.
New national research shows more than two-thirds of TIA patients and, by extension, their treating clinicians, failing to follow through even within 30 days, the maximum recommended window.
The most concerning risk after TIA, also known as “mini-stroke,” is a subsequent damaging stroke.
The American Heart Association, American Stroke Association, American College of Radiology and other medical societies call for the ASAP workup protocol in published guidelines, note the authors of the newly published study, which was conducted at University of Colorado Hospital in Aurora and posted online June 17 in JACR.
To estimate the nationwide rate of guideline adherence, corresponding author Vincent Timpone, MD, and colleagues analyzed Medicare records from more than 6,300 consecutive TIA encounters in emergency departments over a two-year period.
Defining complete TIA imaging as inclusive of cross-sectional brain, brain-vascular and neck-vascular imaging—either brain MRI or brain CT, plus head and neck CTA, head and neck MRI or carotid ultrasound—the team found 60% of patients (n = 3,804) received the full imaging complement while in the ED.
However, of 2,542 patients discharged from the ED with incomplete TIA imaging, just 29.9% (761 patients) followed through within the 30-day window.
No comments:
Post a Comment