Neurology · 13 h ago
US emergency departments increasingly discharge patients with TIA after imaging, study finds
A nationally representative repeated cross-sectional study of more than 2.1 million weighted US emergency department visits for transient ischemic attack (TIA) from 2013 to 2021 found rising discharge and imaging use. Discharge became more common over time, while charges increased; rural encounters had higher discharge rates and lower MRI use than urban encounters.
- Discharge probability rose from 45% to 66%.
- CT angiography and MRI use increased among discharged patients.
- Rural encounters had higher discharge and lower MRI rates.
- Mean charges per discharged encounter increased over time.
Researchers analyzed the 2013-2021 National Emergency Department Sample, a weighted, nationally representative database of US ED visits. The retrospective repeated cross-sectional study included 2,151,408 weighted visits for TIA among adults aged 18 years or older. Outcomes included ED discharge, imaging among discharged patients, and inflation-adjusted charges per discharged encounter.
The adjusted probability of discharge rose from 45% in 2013 to 66% in 2021. Among discharged TIA encounters, CT angiography use increased from 4% to 45%, and MRI use from 17% to 53%. Mean ED charges per discharged encounter increased from $1,746 to $2,755. Across the study years, rural encounters had higher discharge rates and lower MRI use than urban encounters.
The authors suggest these trends may reflect greater use of EDs to expedite evaluation previously conducted during brief hospitalizations. The findings also point to potential cost and ED-throughput consequences, with rural hospitals potentially less able to support this model. As an analysis of coded administrative data, the study describes care patterns and does not establish the quality or outcomes of these approaches.
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JAMA Neurology: Changing Patterns of Transient Ischemic Attack Evaluation in US Emergency Departments ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.