Transient ischemic attack (TIA) and minor stroke are associated with
a substantial risk of subsequent stroke; however, there is uncertainty about
whether such patients require admission to hospital for their initial
management. We used data from a clinical stroke registry to determine the
frequency and predictors of hospitalization for TIA or minor stroke across
the province of Ontario, Canada.
The Ontario Stroke Registry collects information on a
population-based sample of all patients seen in the emergency department
with acute stroke or TIA in Ontario. We identified patients with minor
ischemic stroke or TIA included in the registry between April 1, 2008, and
March 31, 2011, and used multivariable analyses to evaluate predictors of
Our study sample included 8540 patients with minor ischemic stroke
or TIA, 47.2% of whom were admitted to hospital, with a range of 37.6% to
70.3% across Ontario’s 14 local health integration network regions. Key
predictors of admission were preadmission disability, vascular risk factors,
presentation with weakness, speech disturbance or prolonged/persistent
symptoms, arrival by ambulance, and presentation on a weekend or during
periods of emergency department overcrowding.
More than one-half of patients with minor stroke or TIA were not
admitted to the hospital, and there were wide regional variations in
admission patterns. Additional work is needed to provide guidance to health
care workers around when to admit such patients and to determine whether
discharged patients are receiving appropriate follow-up care.