Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Publisher: BMJ Journals, BMA House, London UK
Languages: English
Types: Article
Subjects: STROKE

Classified by OpenAIRE into

mesheuropmc: cardiovascular diseases
Abstract Background: Prompt assessment, investigation and early initiation of secondary prevention after TIA are effective in reducing recurrent stroke. Despite this many patients are slow to seek medical advice. Objective: We performed a systematic review to examine potential factors associated with delay in seeking medical review after TIA. Design: Systematic review. Data-sources: Electronic databases MEDLINE, EMBASE, and Science Citation Index (December 1995 - September 2008). Review methods: Electronic searches were performed for observational studies assessing patient delay in presentation after TIA. Results: Electronic search yielded 9 studies with data on presentation delay in TIA patients; variations existed in study size, population and methodology. A single study included TIA patients only (n=241), whilst the remaining 8 studies recruited both stroke and TIA patients, with TIA patients (n=821) making up only a small proportion of the total patient number (n=3,202). Length of delay varied greatly across all studies; in most studies TIA patients to attending emergency department arrived there within hours. Where patients first presented to their general practitioner 50% attended within 24 hours, whilst 25% waited 2 days or more, and recognition of symptoms as stroke/TIA did not reduce delay. Conclusions: The majority of delay in seeking assessment is due to a lack of response by the patient; many patients do not recognise stroke/TIA symptoms, and even when they do, many fail to seek emergency medical attention. The public needs educating to contact the emergency medical services or attend ED immediately after TIA. (Sprigg, Nikola) (Machili, Chipulwa) (Otter, Mary Edmunds) (Wilson, Andrew) (Robinson, Thompson) University of Leicester - United Kingdom--> , DOSM,Clinical Sciences Buildin, Nottingham City Hospital--> , DOSM,Clinical Sciences Buildin, Nottingham City Hospital--> , Nottingham--> , NG5 1PB--> - UNITED KINGDOM (Sprigg, Nikola) University of Leicester - UNITED KINGDOM (Machili, Chipulwa) University of Leicester - UNITED KINGDOM (Otter, Mary Edmunds) University of Leicester - UNITED KINGDOM (Wilson, Andrew) University of Leicester - UNITED KINGDOM (Robinson, Thompson) UNITED KINGDOM Received: 2008-11-12 Revised: 2009-02-02 Accepted: 2009-02-25
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Adams HP, del Zoppo G, Alberts MJ, Bhatt LB, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks EFM. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655-1711
    • 2. Brown DL, Lisabeth LD, Garcia NM, Smith MA, Morgenstern LB. Emergency department evaluation of ischemic stroke and TIA: the BASIC Project. Neurology. 2004;63(12):2250-2254
    • 3. Coull AJ, Lovett JK, Rothwell PM. Early risk of stroke after a TIA or minor stroke in a population based study. BMJ. 2004;328:326-328
    • 4. Johnston SC, Smith WS. Practice variability in management of transient ischemic attacks. Eur Neurol. 1999;42:105-108
    • 5. Rothwell PM, Coull AJ, Giles MF, Howard SC, Silver LE, Bull LM, Gutnikov SA, Edwards P, Mant D, Sackley CM, Farmer A, Sandercock PAG, Dennis MS, Warlow CP, Bamford JM, Anslow P. Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study). The Lancet. 2004;363:1925-1933
    • 6. Johnson SC, Rothwell PM, Nguyen-Huynh MN, Giles MF. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet. 2007;369:283-292
    • 7. Lavallée PC, Meseguer E, Abboud H, Cabrejo L, Olivot JM, Simon O, Mazighi M, Nifle C, Niclot P, Lapergue B, Klein IF, Brochet E, Steg PG, Lesèche G, Labreuche J, Touboul PJ, Amarenco P. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol. 2007;6:953-960
    • 8. Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJ. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet. 2004;363:915-924
    • 9. Rothwell PM, Giles MF, Chandratheva A, Marquardt L, Geraghty O, Redgrave JN, Lovelock CE, Binney LE, Bull LM, Cuthbertson FC, Welch SJ, Bosch S, CarascoAlexander F, Silver LE, Gutnikov SA, Mehta Z. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet. 2007;370:1432-1442
    • 13. Kwan J, Hand P, Sandercock P. A systematic review of barriers to delivery of thrombolysis for acute stroke. Age and Ageing. 2004;33:116-121
    • 14. Giles MF, Flossman E, Rothwell PM. Patient behavior immediately after transient ischemic attack according to clinical characteristics, perception of the event, and predicted risk of stroke. Stroke. 2006;37:1254-1260
    • 15. Rosamond WD, Gorton RA, Hinn AR, Hohenhaus SM, Morris DL. Rapid response to stroke symptoms: The Delay in Accessing Stroke Healthcare (DASH) study. Academic Emergency Medicine. 1998;5:45-51 18. Yoneda Y, Mori E, Uehara T, Yamada O, Tabuchi M. Referral and care for acute ischemic stroke in a Japanese tertiary emergency hospital. European Journal of Neurology. 2001;8:483-488 Rossnagel K, Jungehulsing GJ, Nolte CH, Muller-Nordhorn J, Roll S, Wegscheider K, Villringer A, Willich SN. Out-of-hospital delays in patients with acute stroke. Annals of Emergency Medicine. 2004;44:476-483 29. Castaldo JE, Nelson JJ, Reed JF, Longenecker JE, Toole JF. The delay in reporting symptoms of carotid artery stenosis in an at-risk population. The Asymptomatic Carotid Atherosclerosis Study experience: a statement of concern regarding watchful waiting. Arch Neurol. 1997;54:1267-1271.
    • 33. Porteous GH, Corry MD, Smith WS. Emergency medical services dispatcher identification of stroke and transient ischemic attack. Prehosp Emerg Care. 1999;3:211-216
  • No related research data.
  • No similar publications.