Rate and associated factors of transient ischemic attack misdiagnosis

摘要

Background and purposeThe goal of this study was to investigate the rate and associated factors of Transient Ischemic Attack (TIA) misdiagnosis.MethodsWe retrospectively analyzed consecutive patients with an initial diagnosis of TIA in the emergency department (ED) in a 9-month period. All hospitalized TIA patients were evaluated by a neurologist within 24?h and had at least one hospital discharge follow-up visit within three months. Patients' clinical data and neuroimaging were reviewed. The final diagnosis was independently verified by two stroke neurologists.ResultsOut of 276 patients with the initial diagnosis of TIA, 254 patients (mean age 68.7?±?15.4?years, 40.9% male, 25.2% final diagnosis of TIA) were included in the analysis. Twenty-four patients (9.4%) were referred to our rapid-access TIA clinic. The rate of TIA misdiagnosis among TIA clinic referred patients was 45.8%. Among the 230 patients in inpatient setting, the rate of TIA misdiagnosis was 60.0%. A hospital discharge diagnosis of TIA was observed in 54.3% of hospitalized patients; however, only 24.8% had the final diagnosis of TIA. Among hospitalized patients, the univariate analysis suggests a significant difference (P?