Pediatric Intrathecal Baclofen Pumps: A Descriptive Analysis of Hospital Course and Associated Costs

2021 ◽  
pp. 1-11
Author(s):  
Jonathan Dallas ◽  
Robert P. Naftel ◽  
Chevis N. Shannon
Keyword(s):  
Descriptive Analysis ◽  
Infusion Pump ◽  
Univariate Analysis ◽  
Intrathecal Baclofen ◽  
Linear Modeling ◽  
Small Hospital ◽  
Hospital Size ◽  
Factors Associated ◽  
Multiple Variables ◽  
Spinal Catheter

<b><i>Introduction:</i></b> The purpose of this study was to identify predictors of increased cost and postoperative length-of-stay (LOS) following intrathecal baclofen pump (ITBP) placement. <b><i>Methods:</i></b> Patients were derived from the 2009/2012 kids’ inpatient database. Inclusion criteria were selected for patients with ICD-9 codes 343.X (infantile cerebral palsy), 86.06 (infusion pump insertion), 03.90 (spinal catheter insertion), and elective hospitalizations. Nonparametric univariate analysis and subsequent gamma log-link general linear modeling were used to identify significant predictors of cost/LOS (<i>p</i> &#x3c; 0.05). <b><i>Results:</i></b> 529 unweighted patients (787 with survey weights applied) met criteria. Median LOS was 3.00 days, and median cost was USD 23,284. Following multivariate modeling, predictors of increased LOS (in days) included increased hospital ITBP volume (<i>p</i> = 0.027), small hospital size (+0.55, <i>p</i> = 0.004), device complications (+0.95, <i>p</i> &#x3c; 0.001), procedural complications (+1.40, <i>p</i> &#x3c; 0.001), additional procedures (+0.86, <i>p</i> &#x3c; 0.001), electrolyte abnormalities (+3.74, <i>p</i> &#x3c; 0.001), and neurological comorbidities (+1.60, <i>p</i> &#x3c; 0.001). Factors associated with decreased LOS were paralysis (−0.53, <i>p</i> &#x3c; 0.001), Northeastern hospital region (−0.55, <i>p</i> = 0.018), and investor-owned hospital status (−0.75, <i>p</i> = 0.001). Similarly, predictors of increased cost included race of Hispanic (+USD 1,156, <i>p</i> = 0.033) or “other” (+USD 2,158, <i>p</i> = 0.001), Northeast hospital region (+USD 4,120, <i>p</i> &#x3c; 0.001), small (+USD 4,139, <i>p</i> &#x3c; 0.001) or medium (+USD 3,368, <i>p</i> &#x3c; 0.001) hospital sizes, additional procedures (+USD 1,649, <i>p</i> &#x3c; 0.001), neurological comorbidities (+USD 3,222, <i>p</i> = 0.003), and increased LOS (<i>p</i> &#x3c; 0.001). Factors associated with decreased cost included Western hospital region (–USD 1,594, <i>p</i> = 0.001), government hospitals (–USD 1,391, <i>p</i> = 0.019), and investor-owned hospitals (–USD 2,057, <i>p</i> = 0.021). <b><i>Conclusion:</i></b> This study found multiple variables associated with increased cost/LOS following ITBP placement. Broadly, this analysis demonstrates national trends associated with increased cost following ITBP placement.

scholarly journals Adequacy of antidote stocking in British Columbia hospitals: The 2005 Antidote Stocking Study

CJEM ◽  
2006 ◽  
Vol 8 (06) ◽  
pp. 409-416 ◽  
Author(s):  
Matthew O. Wiens ◽  
Peter J. Zed ◽  
Katherine J. Lepik ◽  
Riyad B. Abu-Laban ◽  
Jeffrey R. Brubacher ◽  
...  
Keyword(s):  
British Columbia ◽  
Hospital Pharmacy ◽  
Acute Care Hospital ◽  
Future Research ◽  
Care Hospital ◽  
Small Hospital ◽  
Hospital Size ◽  
Information Centre ◽  
Factors Associated ◽  
Made In

ABSTRACTBackground:Inadequate hospital stocking and the unavailability of essential antidotes is a worldwide problem with potentially disastrous repercussions for poisoned patients. Research indicates minimal progress has been made in the resolution of this issue in both urban and rural hospitals. In response to this issue the British Columbia Drug and Poison Information Centre developed provincial antidote stocking guidelines in 2003. We sought to determine the compliance with antidote stocking in BC hospitals and any factors associated with inadequate supply.Methods:A 2-part survey, consisting of hospital demographics and antidote stocking information, was distributed in 2005 to all acute care hospital pharmacy directors in BC. The 32 antidotes examined (21 deemed essential) and the definitions of adequacy were based on the 2003 BC guidelines. Availability was reported as number of antidotes stocked per hospital and proportion of hospitals stocking each antidote. For secondary purposes, we assessed factors potentially associated with inadequate stocking.Results:Surveys were completed for all 79 (100%) hospitals. A mean of 15.6 ± 4.9 antidotes were adequately stocked per hospital. Over 90% of hospitals had adequate stocks ofN-acetylcysteine, activated charcoal, naloxone, calcium salts, flumazenil and vitamin K; 71%–90% had adequate dextrose 50% in water (D50W), ethyl alcohol or fomepizole, polyethylene glycol electrolyte solution, protamine sulfate, and cyanide antidotes; 51%–70% had adequate folic acid, glucagon, methylene blue, atropine, pralidoxime, leucovorin, pyridoxine, and deferoxamine; and &lt;50% had adequate isoproterenol and digoxin immune Fab. Only 7 (8.9%) hospitals sufficiently stocked all 21 essential antidotes. Factors predicting poor stocking included small hospital size (p &lt; 0.0001), isolation (p = 0.01) and rural location (p &lt; 0.0001).Conclusion:Although antidote stocking has improved since the implementation of the 2003 guidelines, essential antidotes are absent in many BC hospitals. Future research should focus on determining the reasons for this situation and the effects of corrective interventions.

scholarly journals Factors associated with child delivery expenditure during the transition to the national implementation of the two-child policy in China

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Shuang Zang ◽  
Jing OuYang ◽  
Meizhen Zhao ◽  
Yalan Zhu ◽  
Jia Liu ◽  
...  
Keyword(s):  
Transition Period ◽  
Univariate Analysis ◽  
Health Financing ◽  
District Level ◽  
Linear Modeling ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Out Of Pocket Payments ◽  
National Implementation ◽  
Health Accounts

Abstract Background This study aimed to analyze the status of birthrates and the characteristics of child delivery expenditure under the Chinese two-child policy’s transition period. We evaluated the socioeconomic factors associated with child delivery and provide evidence for decisions relating to health support for childbirth. Methods Child delivery expense data were obtained from 2015 to 2017 in Dalian, China. A total of 13,535 obstetric records were enrolled using stratified random sampling and the proportional probability to size method. First, we calculated the current curative expenditure of child delivery and health financing in childbirth costs based on the System of Health Accounts 2011 (SHA 2011). Second, univariate analysis of variance and generalized linear modeling were performed to examine factors associated with child delivery expenditure. Third, we classified the included hospitals into the county, district, and municipal hospitals and compared maternal characteristics between these categories. Results Overall, out-of-pocket payments accounted for more than 35% of the total expenditure on child delivery. Median (interquartile range) delivery expenditure at the county and district level hospitals [county-level: 5128.50 (3311.75–5769.00) CNY; district-level: 4064.00 (2824.00–6599.00) CNY] was higher than that at the municipal level hospitals: 3824.50 (2096.50–5908.00) CNY. The increase of child delivery expenditure was associated with an increased ratio of reimbursement, admissions to county and district level hospitals, cesarean sections, and length of stay, as well as a decline in average maternal age (p < 0.05). Conclusions Health financing for childbirth expenditure was not rational during the transition period of the family planning policy in China. Higher delivery expenditure at county and district level hospitals may indicate variations in medical professionalism. Poorly managed hospitalization expenditure and/or nonstandard medical charges for childbirth, all of which may require the development of appropriate public health policies to regulate such emerging phenomena.

scholarly journals Prevalence and factors associated with group B streptococcal colonization in pregnant women

2020 ◽  
Vol 20 (4) ◽  
pp. 1165-1172
Author(s):  
Taís Viana Lédo de Oliveira ◽  
Fabrícia Almeida Fernandes Santana ◽  
Claudio Lima Souza ◽  
Márcio Vasconcelos Oliveira
Keyword(s):  
Pregnant Women ◽  
Skin Color ◽  
Descriptive Analysis ◽  
Univariate Analysis ◽  
Group B Streptococcus ◽  
Latex Agglutination ◽  
Northeastern Brazil ◽  
Cross Sectional ◽  
Factors Associated ◽  
Group B

Abstract Objectives: to estimate the prevalence and the factors associated with the colonization by group B streptococcus (GBS) in pregnant women from the urban area attended at health units in a municipality in northeastern Brazil. Methods: it is a cross-sectional study conducted from January 2017 to March 2018. Vagino-rectal swabs were collected from 210 pregnant women between 32 and 40 weeks of gestation. The swabs were seeded on 5% sheep blood agar and on chromogenic agar. For confirmatory identification of GBS, the CAMP test and latex agglutination were used. Descriptive analysis and univariate and multivariate association analysis were performed using a multinomial logistic model. Results: the prevalence of GBS colonization among pregnant women was 18.1% (n = 38), and a statistically significant association (p<0.05) was found for income and parity variables in the group of older women in the univariate analysis, and for skin color, age and parity in the final multivariate analysis. Conclusions: the prevalence of maternal colonization by GBS was similar to that described in other studies. Although some risk factors, such as skin color, age and parity, were associated with colonization, other studies are essential to establish more information on pregnant women more likely to be colonized by GBS.

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience

2021 ◽  
Vol 10 (2) ◽  
pp. 339
Author(s):  
Vassili Panagides ◽  
Henrik Vase ◽  
Sachin P. Shah ◽  
Mir B. Basir ◽  
Julien Mancini ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Univariate Analysis ◽  
Cerebral Performance Category ◽  
Neurological Impairment ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Factors Associated ◽  
Analysis Survival

Background: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. Methods: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. Results: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). Conclusions: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

2020 ◽  
pp. 1-12
Author(s):  
P J Clamp ◽  
K De-Loyde ◽  
A R Maw ◽  
S Gregory ◽  
J Golding ◽  
...  
Keyword(s):  
Cohort Study ◽  
Otitis Media ◽  
Maternal Education ◽  
Univariate Analysis ◽  
Chronic Otitis Media ◽  
Birth Cohort Study ◽  
Control Group ◽  
Factors Associated ◽  
Prospective Longitudinal

Abstract Objective This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine. Method This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children were used as the control group. Results Univariate analysis demonstrated an association between chronic otitis media and otorrhoea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. Conclusion The association between chronic otitis media and otorrhoea, abnormal tympanograms and grommets supports the role of the Eustachian tube and otitis media (with effusion or acute) in the pathogenesis of chronic otitis media. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding and siblings) were not found to be significant predictors in this analysis.

scholarly journals Predictors of Postoperative Seizure Recurrence: A Longitudinal Study of Temporal and Extratemporal Resections

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hai Chen ◽  
Pradeep N. Modur ◽  
Niravkumar Barot ◽  
Paul C. Van Ness ◽  
Mark A. Agostini ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Intractable Epilepsy ◽  
Seizure Recurrence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Longitudinal Outcome ◽  
Ictal Eeg ◽  
Multiple Variables ◽  
Postoperative Seizure

Objective. We investigated the longitudinal outcome of resective epilepsy surgery to identify the predictors of seizure recurrence. Materials and Methods. We retrospectively analyzed patients who underwent resections for intractable epilepsy over a period of 7 years. Multiple variables were investigated as potential predictors of seizure recurrence. The time to first postoperative seizure was evaluated using survival analysis and univariate analysis at annual intervals. Results. Among 70 patients, 54 (77%) had temporal and 16 (23%) had extratemporal resections. At last follow-up (mean 48 months; range 24–87 months), the outcome was Engel class I in 84% (n=59) of patients. Seizure recurrence followed two patterns: recurrence was “early” (within 2 years) in 82% of patients, of whom 83% continued to have seizures despite optimum medical therapy; recurrence was “late” (after 2 years) in 18%, of whom 25% continued to have seizures subsequently. Among the variables of interest, only resection site and ictal EEG remained as independent predictors of seizure recurrence over the long term (p<0.05). Extratemporal resection and discordance between ictal EEG and resection area were associated with 4.2-fold and 5.6-fold higher risk of seizure recurrence, respectively. Conclusions. Extratemporal epilepsy and uncertainty in ictal EEG localization are independent predictors of unfavorable outcome. Seizure recurrence within two years of surgery indicates poor long-term outcome.

Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer's Disease in China (CPAD) study

2015 ◽  
Vol 28 (2) ◽  
pp. 211-219 ◽  
Author(s):  
Mei Zhao ◽  
Xiaozhen Lv ◽  
Maimaitirexiati Tuerxun ◽  
Jincai He ◽  
Benyan Luo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Family History ◽  
Clinical Pathway ◽  
Help Seeking ◽  
Univariate Analysis ◽  
Positive Family History ◽  
Dementia Care ◽  
Factors Associated ◽  
People With Dementia

ABSTRACTBackground:The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.Methods:Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.Results:The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p= 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p< 0.001). Subtypes of dementia (p< 0.001), family history (p= 0.01), and education level (p= 0.03) were associated with the increased delay in help seeking.Conclusions:In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.

Using population-based routinely collected data from the Sentinel Stroke National Audit Programme to investigate factors associated with discharge to care home after rehabilitation

2017 ◽  
Vol 32 (8) ◽  
pp. 1108-1118 ◽  
Author(s):  
Dipankar Dutta ◽  
Daniel Thornton ◽  
Emily Bowen
Keyword(s):  
Care Home ◽  
Univariate Analysis ◽  
Population Based ◽  
National Institutes Of Health ◽  
National Audit ◽  
Factors Associated ◽  
Routinely Collected Data ◽  
Early Supported Discharge ◽  
Research Findings ◽  
First Time

Objectives: We investigated factors associated with Care Home (CH) discharge following stroke using routinely collected data in unselected patients and assessed the relevance of previous research findings to such patients seen in routine clinical practice. Design: Retrospective analysis of data from the Sentinel Stroke National Audit Programme using univariate analysis and logistic regression. Setting: A large acute and rehabilitation UK stroke unit with access to early supported discharge. Subjects: All patients with stroke treated from 1 January 2014 to 1 January 2017. Main measures: National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Results: Of 2584 patients (median age 78 years, interquartile range (IQR) 69–86; 50.6% male; 86.7% infarcts; median admission NIHSS 4, IQR 2–9), 401 (15.5%) died in hospital and 203 patients (7.9%) were permanently discharged to CH for the first time. Most had pre-discharge mRS scores of 4/5. Factors (odds ratios; 95% confidence intervals) associated with CH discharge included age (1.07; 1.05–1.10), incontinence (11.5; 7.13–19.25), dysphagia (2.13; 1.39–3.29), severe weakness (1.93; 1.28–2.92), pneumonia (1.68; 1.13–2.50), urinary tract infection (UTI) (1.70; 1.04–2.75) and depression (1.65; 1.00–2.72). In a subgroup of all patients with a pre-discharge mRS of 4/5, age (1.04; 1.02–1.06), incontinence (4.87; 2.39–11.02), UTI (2.0; 1.09–3.71) and pneumonia (1.59; 1.02–2.50) were the only factors associated with CH discharge. Conclusion: Potentially modifiable variables like incontinence, UTI and pneumonia were associated with CH discharge, particularly in the severely disabled.

Abstract 90: Cost-Benefit Comparison of Inpatient versus Clinical Decision Unit Management of TIA

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Deepak Nair ◽  
Michael Gibbons ◽  
Huaping Wang ◽  
Min-Chul Kim ◽  
Judi Beck ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Clinical Decision ◽  
Cost Of Care ◽  
Adverse Outcomes ◽  
Stroke Recurrence ◽  
Linear Modeling ◽  
Readmission Rates ◽  
Decision Unit ◽  
Management Protocol ◽  
Clinical Decision Unit

Introduction: Because TIA increases the risk of subsequent stroke, rapid TIA management is key to stroke prevention. Controversy remains regarding the appropriate site of care for TIA patients. Recent literature shows high variability in care processes, admission rates, timeliness of interventions, cost of care, and outcomes, regardless of site of care. We developed a rapid TIA management process in our Clinical Decision Unit (CDU) to reduce cost and adverse outcomes. TIA patients that present to our ED are admitted to the CDU, but transfer patients with TIA are admitted to the inpatient unit (IPU). Methods: Retrospectively, we identified TIA cases by ICD coding, and reviewed records from 4/1/2012 to 3/31/2016 for patients in the CDU and in the IPU. We compared length of stay (LOS), cost of care, readmission rates, and TIA/stroke recurrence between the two groups. Statistical analysis included Chi-square and Wilcoxon two-sample test for recurrence and readmission rates, and generalized linear modeling and Poisson analysis for LOS and cost analysis. Results: A total of 731 patients presented for TIA management in the study period; 393 in CDU, and 338 in IPU. There was no statistical difference in age or sex between the two groups. Mean LOS (hours) in CDU vs IPU was 15 vs 108 (p<0.001), respectively. Total cost of care in CDU vs IPU was $3,835 vs $11,904 (p<0.001), respectively. Univariate analysis showed no appreciable difference in recurrent TIA or stroke rates; multivariate analysis of stroke recurrence for CDU (1.0%) vs IPU (3.6%) did show a small difference (p=0.024). When factoring in reduction of stroke recurrence, the final cost savings of the CDU program equaled $8,258 per patient. There was no difference in readmission rates between the two groups. Conclusion: Using a rapid TIA management protocol yielded a significantly lower LOS and cost per patient. This may justify an avoidance of inpatient admission for TIA patients.

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