ABSTRACT NUMBER: ESOC2026A1422 STROKE AND TIA MIMIC ANALYSIS AT THE TIA CLINIC IN A TERTIARY COMPREHENSIVE STROKE CENTRE

Abstract Background and aims International data show that stroke mimics account for up to 31% of stroke presentations and up to 60% of potential TIAs. Making an astute clinical decision based on history and examination is important. We reviewed our TIA clinic data to explore this following the institution of robust action plans to decrease the mimic rate. This QIP studied the relationship between mimic rate and existing referral pathways at a comprehensive stroke centre. Methods We retrospectively analysed data over a 6-month period in 2025, calculating the mimic-rate based on referral sources and other demographic features. Results A variety of mimics were referred as TIA. Of 990 patients 63.9% (n= 633) were mimics and 56.8% (n=360) females. Among the < 60 yr olds, 79.3% (n=277) were mimics, constituting 43.7% of the total mimic population. The ED and GPs referred the majority of patients - 79.8% (n=791). Two-thirds (61%, 69%) of these were mimics. Migraine diagnosis contributed to a third of stroke mimics cohort. Conclusions Despite robust referral pathways the mimic rates in TIA clinics have increased to 63.9%, with large proportions referred from ED and GP. With current pressures in ED and GP, there has been a low threshold amongst clinicians to refer patients into TIA pathway though not meeting the standard criteria for referral. Robust vetting of referrals, e-Triage system and close collaboration with other specialities like neurology is crucial in management of mimics. Regular teaching and shared learning between primary and secondary care facilitate appropriate referral systems. Conflict of interest Kamya Rangarajan: Nothing to disclose, Dr Senthil Raghunathan: Nothing to disclose, Dr Sunil Munshi: Nothing to disclose, Dr Sharvari Inamdar: Nothing to disclose, Dr Ashit Shetty: Nothing to disclose