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
Sprigg, Nikola; Machili, C.; Otter, M.E.; Wilson, A.; Robinson, T.G. (2009)
Publisher: BMJ Publishing Group
Languages: English
Types: Article
Subjects: STROKE

Classified by OpenAIRE into

mesheuropmc: cardiovascular diseases, nervous system diseases, parasitic diseases
Background: Prompt assessment and investigation of\ud transient ischaemic attack (TIA) followed by early\ud initiation of secondary prevention is effective in reducing\ud recurrent stroke. Nevertheless, many patients are slow to\ud seek medical advice after TIA. A systematic review was\ud undertaken to examine potential factors associated with\ud delay in seeking medical review after TIA.\ud \ud Methods: The electronic databases MEDLINE, EMBASE,\ud and Science Citation Index were searched for observational\ud studies assessing patient delay in presentation after\ud TIA. The search was restricted to studies published\ud between December 1995 and September 2008.\ud \ud Results: The electronic search yielded nine studies with\ud data on presentation delay in patients with TIA; variations\ud existed in study size, population and methodology. One\ud study included patients with TIA only (n=241), whereas\ud the remaining eight studies recruited both stroke and TIA\ud patients. Overall, TIA patients (n=821) made up only a\ud small proportion of the total number of patients in this\ud analysis (n=3,202). Length of delay varied greatly across\ud all studies. In most studies, patients with TIA who\ud attended an emergency department arrived there within\ud hours. Where patients first presented to their general\ud practitioner, 50% attended within 24 hours whereas 25%\ud waited 2 days or more. Recognition of symptoms as\ud stroke/TIA did not reduce the delay.\ud \ud Conclusions: The majority of delay in seeking assessment\ud after TIA is due to a lack of response by the\ud patient—many patients do not recognise the symptoms\ud of stroke/TIA, and even when they do, many fail to seek\ud emergency medical attention. The public needs educating\ud on the importance of contacting the emergency medical\ud services or attending an emergency department immediately\ud after TIA.
  • 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.