Does emergency department blood pressure influence hospital length of stay for transient ischemic attack?

Study objectives: We determine whether systolic (sBP) or diastolic (dBP) blood pressure affect the hospital length of stay for patients with transient ischemic attack (TIA). Methods: This study was conducted at a tertiary referral academic medical center emergency department with an annual census of 70,000 visits. A total of 244 unique patients presented between December 2001 and December 2003 with an ultimate discharge diagnosis of TIA ( International Classification of Diseases, Ninth Revision code 435), of whom 235 consented to be included in the study. This study was approved by the authors' institutional review board. Data on blood pressure were collected at triage by a nurse blinded to the study, using a standard stethoscope and manual sphygmomanometer. Information on length of stay if the patient was admitted as an inpatient was also collected. Results: Of the total study cohort of 235 patients, 109 (46%) were female patients and 126 (54%) were male patients. The mean age was 73.1 years (SD 13.3 years, range 25 to 94 years). The median length of stay was 2 days (mean 3.1 days, SD 3.1, range 0 to 15 days). Five patients were not admitted to the hospital at all but rather discharged home from the ED. Using the Kruskal-Wallis test, neither the sBP ( P =.34; Table 1) nor the dBP ( P =.57; Table 2) levels (according to the categories listed below) were identified as being significantly associated with length of stay. Conclusion: Blood pressure in the ED does not appear to influence the length of stay in patients with TIA. These results likely reflect the heterogeneity of TIA as a disease process, as well as the variation in practice with regard to hospitalization and subsequent hospital discharge.Table 1, abstract 64sBP LevelsMedian HLOS 220 (n=11)2 HLOS, Hospital length of stay.Table 2, abstract 64dBP LevelsMedian HLOS 120 (n=3)3.0