![]() Missing data were not included in the analyses. Searching the literature, we were able to identify eight comorbidities previously associated with TGA: epilepsy (ICD-9 code 345), migraine headache (ICD-9 code 346), precerebral disease (atherosclerosis) (CCS code 110), stroke (CCS code 109), atrial fibrillation (CCS code 106), hypertension (CCS code 98), hyperlipidemia (CCS code 53), and diabetes mellitus (CCS codes 49, 50). To analyze TGA hospitalizations, we identified all hospital discharges for which an ICD-9-CM code of 437.7 (transient global amnesia) was listed. A unique hospital identifier allows linkage of discharge data to an NIS data set with hospital characteristics. We assumed that each discharge or encounter appeared only once per patient. The unit of analysis was the discharge or encounter rather than the individual. Detailed information on the design of the NIS is available online ( ). To allow extrapolation for national estimates, both hospital and discharge weights are provided. All discharges from sampled hospitals for the calendar year are then selected for inclusion into NIS. The sampling strategy selects hospitals nationwide from the State Inpatient Database according to defined strata based on ownership, bed size, teaching status, urban or rural location, and region. Information collected by the NIS includes basic demographic data, ICD-9 diagnoses, procedural coding, financial data, and discharge data, including the length of stay and total cost of hospitalization. The data were collected in a manner whereby we could perform weighted analysis representing the total population of the United States. community hospitals, comprising 5–8 million inpatient records per year. The NIS is a database maintained as a part of the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality. In an effort to better characterize TGA, we have examined the Nationwide Inpatient Sample, which is uniquely suited to evaluate the incidence of rare diseases, such as TGA.ĭata were obtained from the Nationwide Inpatient Sample (NIS) for the years 1999–2008. 16 Numerous associations with other possible triggers have been reported 2 yet, none of these correlations have been validated in a nationwide database. 14, 15 Migraines and epilepsy have also been implicated as potential correlates of TGA. 10 – 13 More recent studies have focused on the discovery that a large percentage of TGA patients have jugular venous insufficiency. High-resolution brain MRI of TGA patients suggests diffusion restriction in the hippocampi. Because of the implicated loss of declarative memory, ischemia in bilateral hippocampi has been suggested as a possible cause. 9 Past studies have attempted to correlate TGA to vascular risk factors, migraine, and epilepsy, with variable results. 7, 8ĭespite the general acceptance of TGA as a clinical entity, its etiology has yet to be determined. 4 – 6 The average age of onset has ranged between 50–80 years, with an incidence of approximately 5–11 per 100,000 per year. Previous studies on TGA have been inconsistent regarding sex prevalence. 1 – 3 Though generally self-limited with rare recurrences, this striking presentation has spurred efforts to link TGA to more consequential and treatable conditions. Transient global amnesia (TGA) is an uncommon amnestic syndrome characterized by a combined anterograde and retrograde amnesia of sudden onset. All minority populations showed a lower rate of diagnosis that fell short of statistical significance. Patients with migraines and patients classified as Caucasian had higher odds of being diagnosed with TGA. TGA was associated with lower hospital charges ($14,242 versus $21,319), shorter hospital stays (mean days: 2.49 versus 4.72 ), and routine hospital discharges (91.4% versus 74.5%). The odds of being diagnosed with TGA was lower among African Americans and Hispanics as well as among patients classified as Asian/Other, compared with Caucasians. Similarly, patients with TGA were more likely to have hypertension, precerebral disease, and hyperlipidemia. Patients with migraines were 5.98 times more likely to also have a diagnosis of TGA compared with patients without migraines. Descriptive and survey logistic regression analyses were conducted and adjusted for influence of comorbidities, demographic characteristics, and hospitalization-related factors. Data were obtained from the Nationwide Inpatient Sample using ICD-9 and procedure codes. The purpose of this article was to explore sex- and race-specific variables and comorbidities associated with transient global amnesia (TGA) using a nationally representative database.
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