{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T10:51:38Z","timestamp":1778583098105,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,2,18]],"date-time":"2018-02-18T00:00:00Z","timestamp":1518912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS082367"],"award-info":[{"award-number":["K23NS082367"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose:<\/jats:title>\n                    <jats:p>The significance of transient neurological attack (TNA) symptoms is unclear. We sought to determine the risk of ischemic stroke after discharge from the emergency department (ED) with a diagnosis consistent with symptoms of TNA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using administrative claims data, we identified patients discharged from EDs in New York between 2006 and 2012 with a primary discharge diagnosis of a TNA symptom, defined as altered mental status, generalized weakness, and sensory changes. The primary outcome was ischemic stroke. We used Kaplan-Meier survival statistics to calculate cumulative rates, and Cox regression to compare stroke risk after TNA versus after transient ischemic attack (TIA; positive control) or renal colic (negative control) while adjusting for demographics and vascular risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 499 369 patients diagnosed with a TNA symptom and discharged from the ED, 7756 were hospitalized for ischemic stroke over a period of 4.7 (\u00b11.9) years. At 90 days, the cumulative stroke rate was 0.29% (95% confidence interval [CI]: 0.28%-0.31%) after TNA symptoms versus 2.08% (95% CI: 1.89%-2.28%) after TIA and 0.03% (95% CI: 0.02%-0.04%) after renal colic. The hazard ratio (HR) of stroke was higher after TNA than after renal colic (HR: 2.13; 95% CI: 1.90-2.40) but significantly lower than after TIA (HR: 0.47; 95% CI: 0.44-0.50). Compared to TIA, TNA was less strongly associated with stroke among patients under 60 years of age compared to those over 60.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients discharged from the ED with TNA symptoms faced a higher risk of ischemic stroke than patients with renal colic, but the magnitude of stroke risk was low, particularly compared to TIA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1941874417750996","type":"journal-article","created":{"date-parts":[[2018,2,18]],"date-time":"2018-02-18T23:47:13Z","timestamp":1518997633000},"page":"135-140","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Ischemic Stroke After Emergency Department Discharge for Symptoms of Transient Neurological Attack"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8802-2380","authenticated-orcid":false,"given":"Neal S.","family":"Parikh","sequence":"first","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA"},{"name":"Department of Neurology, Columbia University, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander E.","family":"Merkler","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA"},{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin R.","family":"Kummer","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA"},{"name":"Department of Biomedical Informatics, Columbia University, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA"},{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,2,18]]},"reference":[{"key":"bibr1-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.22.2901"},{"key":"bibr2-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000129482.70315.2F"},{"key":"bibr3-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"bibr4-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70248-X"},{"key":"bibr5-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.24.2877"},{"key":"bibr6-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.4.768"},{"key":"bibr7-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24539"},{"key":"bibr8-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016743"},{"key":"bibr9-1941874417750996","unstructured":"Barrett M, Steiner C, Andrews R, Kassed C, Nagamine M. Methodological issues when studying readmissions and revisits using hospital administrative data. HCUP Methods Series Report # 2011-01. https:\/\/www.hcup-us.ahrq.gov\/reports\/methods\/2011_01.pdf. Accessed March 9, 2011."},{"key":"bibr10-1941874417750996","unstructured":"User guide: HCUP supplemental variables for revisit analysis. Healthcare Cost and Utilization Project (HCUP). 12 20, 2017. Agency for Healthcare Research and Quality, Rockville, MD. https:\/\/www.hcup-us.ahrq.gov\/toolssoftware\/revisit\/UserGuide_SuppRevisitFilesCD.pdf. Accessed September 20, 2017."},{"key":"bibr11-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2312"},{"key":"bibr12-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24521"},{"key":"bibr13-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000032240.28636.BD"},{"key":"bibr14-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60150-0"},{"key":"bibr15-1941874417750996","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S144441"},{"key":"bibr16-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414539055"},{"key":"bibr17-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.597070"},{"key":"bibr18-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035923"},{"key":"bibr19-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2012.11.012"},{"key":"bibr20-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70299-5"},{"key":"bibr21-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.06.559"},{"key":"bibr22-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.577650"},{"key":"bibr23-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.22.2417"},{"key":"bibr24-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.07.001"},{"key":"bibr25-1941874417750996","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61448-2"}],"container-title":["The Neurohospitalist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1941874417750996","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1941874417750996","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1941874417750996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:52:37Z","timestamp":1777589557000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1941874417750996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,18]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1177\/1941874417750996"],"URL":"https:\/\/doi.org\/10.1177\/1941874417750996","relation":{},"ISSN":["1941-8744","1941-8752"],"issn-type":[{"value":"1941-8744","type":"print"},{"value":"1941-8752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,18]]}}}