TY -的T1 - TIA摩根富林明全省范围的筛选系统的影响- - -神经学乔-神经病学SP - e2093 LP - - 10.1212 /首页 WNL e2102做。0000000000207201六世- 100 - 20 AU - Thomas j . Jeerakathil盟艾米迎鑫玉盟-菲利普·贝拉Choi盟方Shoufan盟-阿什法克Shuaib AU -苏米特r . Majumdar盟安德鲁·m·Demchuk AU -肯尼斯·屠夫盟蒂姆·j·沃森AU - Naeem院长盟Deb戈登AU - Michael d .希尔盟-凯西爱德蒙盟Shelagh b . Coutts盟为追求调查员Y1 - 2023/05/16 UR - //www.ez-admanager.com/content/100/20/e2093.abstract N2 -背景和目标紧急短暂性脑缺血发作(TIA)管理以减少中风复发是具有挑战性的,尤其是在农村和偏远地区。首页加拿大阿尔伯塔省,尽管中风有组织的系统,从1999年到2000年的数据显示,中风复发TIA后高达9.5%,90天。我们的目标是确定一个多方面的以人群为基础的干预导致减少复发TIA后中风。方法在准实验卫生服务研究的干预研究中,我们实现了一个TIA管理算法在整个省,集中在一个24小时医生的TIA热线TIA和公共教育和医疗提供者。从管理数据库,我们联系急诊科出院小结出院摘要确定事件tia和复发性中风90天在一个单一付款人系统验证的复发性中风事件。主要结果是中风复发;二级综合结果的复发性中风、急性冠脉综合征,全因死亡。我们使用了一个中断时间序列回归分析的年龄调整和sex-adjusted中风TIA后复发率,结合2年preimplementation时期(2007 - 2009),15个月实现期和2年postimplementation时期(2010 - 2012)。使用逻辑回归检验结果不符合时间序列模型。Results We assessed 6,715 patients preimplementation and 6,956 patients postimplementation. The 90-day stroke recurrence rate in the pre-Alberta Stroke Prevention in TIA and mild Strokes (ASPIRE) period was 4.5% compared with 5.3% during the post-ASPIRE period. There was neither a step change (estimate 0.38; p = 0.65) nor slope change (parameter estimate 0.30; p = 0.12) in recurrent stroke rates associated with the ASPIRE intervention implementation period. Adjusted all-cause mortality (odds ratio 0.71, 95% CI 0.56–0.89) was significantly lower after the ASPIRE intervention.Discussion The ASPIRE TIA triaging and management interventions did not further reduce stroke recurrence in the context of an organized stroke system. The apparent lower mortality postintervention may be related to improved surveillance after events identified as TIAs, but secular trends cannot be excluded.Classification of Evidence This study provides Class III evidence that a standardized population-wide algorithmic triage system for patients with TIA did not reduce recurrent stroke rate.APSS=Alberta Provincial Stroke Strategy; ASPIRE=Alberta Stroke Prevention in TIAs and Mild Strokes; DAD=Discharge Abstracts Database; ED=emergency department; IQR=interquartile range; TIA=transient ischemic attack ER -