Background: A growing body of research indicates that fatigue is a common and debilitating sequel of both ischemic and hemorrhagic stroke affecting roughly half of all survivors. However, in patients with minimal to no residual symptoms (mild stroke and TIA) the prevalence and impact is unknown.
Objective: To evaluate the prevalence and functional impact of fatigue among patients with mild stroke and TIA.
Design/methods: A retrospective observational cohort questionnaire-based study from July 2016-July 2017 was conducted on patients presenting to stroke clinic for the first-time after hospital discharge and completed during the visit. A total of 72 patients (58 ischemic, 5 ICH and 9 TIA) were analyzed. Chart review of clinical data including demographics, stroke type, NIHSS, mRS, level of education, work status, living situation, vascular risk factors, and history of depression was completed. The Fatigue Assessment Scale (FAS) was utilized to determine level of fatigue. A score of 22 or higher indicated fatigue. Statistical significance was calculated using Pearson’s Chi-square and Fisher’s exact testing.
Result: Among all patients, median age was 62.5 years 64% were men and 70.8% Caucasian. The median discharge NIH score was 1.5 and 90% were evaluated within the first 12 weeks of hospital discharge. Approximately 42% of patients reported fatigue (n=30) and 19% (n=14) reported new fatigue since their event. Concomitant depression was observed in 45% of fatigued patients (n=13). Fatigue was most commonly observed among patients with an ischemic MCA territory infarction (p=.007). Patients with fatigue were less likely to drive a car (p=.04) and a trend towards being less likely to have returned to work was observed (p=.053).
Conclusions: A higher than expected proportion of patients with mild stroke or TIA report fatigue and roughly 1 in 5 reported new fatigue since their event despite only half of patients experiencing depression. Continued research is needed to better understand predictors of fatigue and its long term impact among these patients.