ED visits for ischemic stroke, TIA declined in past decade

The rate of ED visits due to ischemic stroke or transient ischemic attack in the United States declined from 2001 to 2011, particularly among adults aged 55 to 74 years, according to a data brief released by the National Center for Health Statistics.

From 2001 to 2011, the total age-adjusted rate of ED visits due to ischemic stroke or TIA decreased by 35% among adults, from 40 visits per 10,000 people to 26 per 10,000 people. This decline was significant and most pronounced among those aged 55 to 74 years (51% decrease, from 68 visits per 10,000 people to 33 per 10,000 people). The rate of ED visits did not change from 2001 to 2011 for younger adults.

Researchers noted that the ED visit rate among patients aged at least 75 years decreased by 26% during the evaluated time period; however, there was no change in this rate from 2006 to 2011 for this age group.

Among patients younger than 75 years, the researchers observed a decline in the rate at which patients treated at an ED for ischemic stroke or TIA arrived by ambulance: 41% in 2004 to 2005 vs. 24% in 2010 to 2011. This rate did not change among patients aged at least 75 years during the study period.

The proportion of patients with ischemic stroke or TIA who were transferred to another hospital after initial ED admission also increased, from 71% in 2001 to 78% in 2011. This proportion did not change among patients admitted for other diagnoses during the same period.

Use of MRI or CT testing in patients with ischemic stroke or TIA increased from 66% of cases in 2001 to 92% in 2011. An increase in MRI or CT use also occurred among patients with other diagnoses, but was most pronounced in this patient population.

“While stroke remains a leading cause of death and disability in the United States, mortality from stroke has been declining,” Anjali Talwalkar, MD, MPH, and Sayeedha Uddin, MD, MPH, both medical officers for the National Center for Health Statistics, wrote in the data brief. “This report demonstrates that the age-adjusted ED visit rate for stroke or TIA has also been declining. … Monitoring visits to [EDs] will continue to be important to assess the impact of public health campaigns to promote rapid emergency care of stroke and TIA and to describe the burden of these conditions on the U.S. health care system.” – by Adam Taliercio

Disclosure: Talwalkar and Uddin are employees of the CDC’s National Center for Health Statistics, Division of Health Care Statistics.