• Yaron Niv, Michael Kuniavsky, Olga Bronshtein, Nethanel Goldschmidt, Shuli Hanhart, Alexander Konson, and Hannah Mahalla.
• Israeli National Program for Quality Indicators (INPQ), Ministry of Health, Jerusalem, Israel.
• Isr Med Assoc J. 2021 Jun 1; 23 (6): 369-372.

BackgroundWith diagnostic imaging, such as a duplex of the carotid arteries, finding of stenosis and atherosclerotic plaque and consequent end arterectomy may be important for decreasing the danger of developing cerebrovascular accident after transient ischemic attack (TIA).ObjectivesTo measure performance rates of duplex of carotid arteries within 72 hours of TIA diagnosis.MethodsThe denominator included all patients who were admitted to emergency departments because of TIA, and the numerator included those who underwent duplex within 72 hours of admission. Inclusion criteria included all patients older than 18 years who were admitted because of TIA according to the ICD9 codes.ResultsMeasuring this indicator started in 2015 with 5504 patients and a 58% success rate. The figures for the years 2016, 2017, and 2018 were 5309, 5447, and 5278 patients with success rates of 73%, 79%, and 83%, respectively. Six of 26 hospitals (23.0%) reached the target of 80% in 2018. From 2015 to 2018 a total of 21,538 patients were admitted to emergency departments in Israel and diagnosed with TIA. Of these, 15,722 (72.9%) underwent duplex within 72 hours. The mortality rate within 30 days from diagnosis was 0.81% in patients who performed duplex within 72 hours of diagnosis and 2.37% in patients who did not, odds ratio 2.676, 95% confidence interval 2.051-3.492, P < 0.0001. These results indicate a statistically significant decrease of 65.82.ConclusionsA significant decrease in mortality was noted in patients with a new diagnosis of TIA who underwent duplex within 72 hours of diagnosis.

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