346 A RETROSPECTIVE REVIEW OF THE PREVALENCE, MANAGEMENT AND SPECIALIST REVIEW OF TIA DIAGNOSIS

Abstract

Abstract Background Transient Ischaemic Attach (TIA) and suspected TIA are common presentations to emergency departments and stroke services, often heralding a subsequent stroke in up to 25% of patients. The first week after TIA symptom onset carries a significant risk of impending stroke, reported risk at 2 days of between 2.0 and 4.1%, and at 7 days of between 3.9 and 6.5%. As such, a TIA presentation may offer an opportunity to reduce the significant risk of chronic morbidity and mortality. Methods We conducted a retrospective review of all patient records with a diagnosis of TIA on their clinical discharge summary using the HIPE system from June 2020 to June 2021. Results Two-hundred and Sixty-nine patients were recruited into the study. 77 patients without discharge letters or incomplete medical information were excluded. The remaining 192 were analysed. Mean age was 75 (+/-10), 45.8% (n=88) patients were male and average length of stay 3.9 days. 52.6% (n=101) were followed up in designated TIA or Neurology OPD, 42.2% (n=81) were confirmed TIA. 10.4%(n=20) were diagnosed with another pathology. 47.4% (n=91) did not have any OPD follow up care. 100% of OPD confirmed TIA cases (n=81) were on anti-platelet or anticoagulation therapy. 4 out of 9 confirmed TIA cases with high HbA1c levels had no prior history of diabetes. 4.2% (n=8) were actively smoking and not on nicotine replacement therapy. 27.2% (n=22) had a history of previous TIA. Conclusion Accurate TIA recognition and management remains crucial to stroke prevention. Outpatient follow up in TIA and Neurology clinics can improve TIA diagnosis and guide appropriate management. Despite guidelines recommending an early referral to a stroke team, almost half (47%) of those patients diagnosed with TIA during admission did not have OPD follow up. TIA mimics represent a considerable pitfall in TIA diagnosis for NCHDs.