Post-emergency Management of Patients With Transient Ischemic Attack

Transient Ischemic Attack Clinical Trial

Official title:

Post-emergency Management of Patients With Transient Ischemic Attack

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06170034
• Other study ID #: PEC AIT 84
• Status: Recruiting
• Start date: November 16, 2023
• Est. completion date: June 16, 2024

Study information

• Verified date: December 2023
• Source: Centre Hospitalier Henri Duffaut - Avignon
• Contact: Marilyne Grinand, PhD
• Phone: (+33)432759392
• Email: grinand.marilyne[@]ch-avignon.fr
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

A transient ischemic attack (TIA) is a momentary neurological dysfunction due to a brief cessation of blood flow to a region of the brain, resulting in typical signs of stroke (hemiplegia, aphasia, dysarthria), but whose clinical symptoms typically last less than an hour, with no visible lesion on imaging. This diagnosis remains difficult and is essentially based on the clinical judgment of the physician.

Because a TIA can be a "pre-alarm" for stroke in 20-30% of cases, it needs to be treated appropriately and as early as possible in the emergency department. Stroke rates after untreated TIA are 5% within 48 hours, 10% within one month and 20% within one year. This risk is calculated using the ABCD² score which is based on the patient's risk factors and the clinical manifestations of TIA. Patients with a score ≥ 3 should be hospitalized as soon as possible for a complete medical evaluation. However, this score has not been scientifically validated, and several specialists agree that all TIAs should be evaluated immediately. Preventing stroke is a major public health issue because it is a serious, disabling and sometimes fatal disease. Given the seriousness of the progression from TIA to stroke, the French National Authority for Health has issued a series of management recommendations. However, in practice, these guidelines remain complicated to follow and patients management may vary and be more or less effective.

Therefore, the aim of this study is to highlight the differences in how inpatients and outpatients are managed. Following these observations, solutions will be sought to make the care and management of these patients more efficient and more in line with recommendations.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 140
• Est. completion date: June 16, 2024
• Est. primary completion date: May 16, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patient over 18 years old.

• Consultation in the emergency department.

• Suspected TIA diagnosed by emergency physician.

• Duration of TIA symptoms <1 hour.

Exclusion Criteria:

• Validation MRI performed prior to suspected TIA.

• Patient hospitalized for a condition other than TIA, including stroke.

• Patient referred to another hospital for further examination.

• Pregnant women.

• Patient unable to understand and answer a questionnaire.

• Patient under legal protection.

Related Conditions & MeSH terms

• Emergencies
• Ischemia
• Ischemic Attack, Transient
• Transient Ischemic Attack

Intervention

Behavioral:
• Satisfaction questionnaire
Satisfaction questionnaire to assess how TIA patients feels about their medical care.

Other:
• Medical care questionnaire
Recording appointments and results of examinations and consultations in TIA management

Locations

Country	Name	City	State
France	Centre Hospitalier d'Avignon	Avignon	Provence-Alpes-Côte d'Azur

Sponsors (1)

Lead Sponsor	Collaborator
Centre Hospitalier Henri Duffaut - Avignon

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Assess time between arrival in the emergency department for suspected TIA patients and MRI.		Baseline
Secondary	Time between arrival in the emergency department and MRI by departments.		Baseline
Secondary	Time between arrival in the emergency department and MRI by ABCD² score.		Baseline
Secondary	Percentage of patients with complete TIA management by departments.		Baseline
Secondary	Hospitalization times according to care units		Baseline
Secondary	Hospitalization times according to complete TIA management		Baseline
Secondary	Percentage of patients with secondary event, according to complete TIA management		Baseline
Secondary	Number of outpatients without complete TIA management one month after TIA.		At 1 month follow-up
Secondary	Patient satisfaction with a short questionnaire		At 1 month follow-up