Recent studies have found that chronic fatigue can extend for at least a year after a Transient Ischemic Attack (TIA). This is in direct conflict with the long-held assumption that TIAs produce no meaningful long-term impact. This study highlights the importance of a proactive approach to screening for fatigue in patients following a TIA. It is important to accomplish this even when these patients are appearing neurologically intact.
Countering the concerns about implementation and maintenance costs, participants would have been those who had experienced TIAs in the past 30 days. The only initial assessment, which involved a swab test of nasopharyngeal swabs, occurred at least 20 days after first presentation of symptoms. To address this issue, researchers used two questionnaires to assess fatigue in study participants. At baseline, over 61% of participants stated they experienced pathologic fatigue. This extreme level of fatigue has a profound impact on their everyday lives.
One year later, a follow-up survey revealed that 53.8% of these individuals still suffered from pathologic fatigue. Alarmingly, more than 60% of those who were fatigued at baseline remained fatigued after 12-months follow-up. These findings underscore a troubling trend in the recovery for TIA patients. They will require supplemental services and targeted interventions to achieve positive outcomes.
Cheng-Han Chen, MD, is one of the leading investigators in the study. He stressed the need for rigorous surveillance to identify fatigue in TIA patients.
“By identifying the patients who develop fatigue soon after a transient ischemic attack, we are better able to focus our efforts to support these patients to manage their symptoms and improve their quality of life. We traditionally think of transient ischemic attacks as short-lived events that have limited long-term impact on patients. Based on these findings, we should consider improved screening to identify these patients at risk for suffering longer-term consequences to their quality of life.” – Cheng-Han Chen
Interestingly, the study found that 13.1% of participants who were pathologically fatigued at baseline had acute infarction. By comparison, the group who did not report having fatigue had 19.8% of them impacted. Only 22.5% of participants who did not have pathologic fatigue at baseline reported it at the 12-month follow-up.
Christopher Yi, MD, the third researcher on the project, highlighted the importance of discussing fatigue at follow-up visits.
“Fatigue should be proactively assessed during follow-ups after a transient ischemic attack, even in patients who seem neurologically intact. Additionally, patients should be made aware that transient ischemic attacks can have ongoing effects, which might improve expectations and support seeking timely care.” – Christopher Yi
These surprising findings upend the conventional wisdom around TIAs and shine a spotlight on an area of post-attack care that still leaves much to be desired. If all this sounds familiar, you might not be aware that you’re at risk for long-term fatigue. The early identification of fatigue may allow for more targeted interventions and result in improved quality of life for these patients.
Overall, this study highlights the need for in-depth followup care for patients after a TIA. Healthcare providers can better identify chronic fatigue as a possible symptom. This enables them to provide focused interventions that tackle this frequently-ignored effect of TIAs.
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