Factors associated with onset-to-door time in patients with transient ischemic attack admitted to stroke centers

Stroke. 2014 Feb;45(2):611-3. doi: 10.1161/STROKEAHA.113.003367. Epub 2013 Nov 21.

Abstract

Background and purpose: The aim of this study was to elucidate the factors associated with the time from symptom onset to arrival at a stroke center (onset-to-door time [ODT]) in patients with classically defined transient ischemic attack using data from a multicenter, retrospective study.

Methods: The subjects were patients with transient ischemic attack admitted to 13 stroke centers in Japan within 7 days of onset between 2008 and 2009. A total of 464 patients registered (292 men, 68.5±13.2 years old), and 421 of them (268 men, 68.8±13.1 years old) were included in the analyses. ODT was classified into the following 5 categories: <3 hours, 3 to 6 hours, 7 to 12 hours, 13 to 24 hours, and >24 hours.

Results: There were 233 patients (55.3%) who visited a stroke center within 3 hours of symptom onset. Multiple ordinal logistic regression analysis revealed that motor weakness, speech disturbance, and duration of symptoms >10 minutes were independently associated with a short ODT. Furthermore, a history of transient ischemic attack and hypertension and a referral from another medical facility were independently associated with a long ODT. Patients with a higher ABCD2 score were likely to arrive at a stroke center more quickly.

Conclusions: We identified several factors that were positively and negatively associated with the ODT in patients with transient ischemic attack.

Keywords: ischemic attack, transient; stroke.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Hospital Units
  • Humans
  • Hypertension / etiology
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / therapy*
  • Japan
  • Logistic Models
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Referral and Consultation
  • Retrospective Studies
  • Speech Disorders / etiology
  • Stroke / diagnosis
  • Stroke / therapy*
  • Time Factors
  • Treatment Outcome