Background/Aims:
In patients who experience a transient ischaemic attack (TIA), hospital admission is indicated if there is significant internal carotid artery (ICA) stenosis as there is a ten to twenty per cent risk of recurrent TIAs or stroke in the following ninety days. Otherwise, further TIA workup can be completed as an outpatient. The aims of this audit were (1) determine the radiological burden of performing computed tomography angiogram (CTA) in the emergency department setting, (2) determine the incidence of significant ICA findings and incidental findings, and (3) determine how many patients discharged with a diagnosis of TIA met the Explicit Diagnostic Criteria for Transient Ischaemic Attack (EDCT).
Methods:
This audit analysed data from patients discharged from a tertiary hospital in Perth, Australia in 2023 with a primary diagnosis of TIA (271 patients). The audit looked at carotid imaging on presentation, significant findings (both ICA findings and incidental findings), and EDCT score.
Results:
Of the 271 patients, 142 patients (52.4%) had CTA on emergency department (ED) presentation. Forty-five patients (16.6%) had significant ICA findings and 30 patients (11.1%) had incidental findings. One hundred and seventy-two (63.5%) patients met the full EDCT criteria for a TIA, with the limitation that scores were calculated retrospectively from patient notes.
Conclusions:
TIA admissions may be reduced by up to 84% by only admitting patients with significant carotid findings. EDCT scoring would be a useful tool in ED to accurately identify presentations requiring TIA workup.