1. The Research Question Aim TIA is defined by short-lasting symptoms
Medical management focuses on stroke prevention
Aim
Investigate the association between TIA and consultations for fatigue, cognitive, or psychological impairment in primary care.
It is assumed that there are no ongoing impairments after TIA after short lasting symptoms have resolved. Follow up is focused on stroke prevention. However, anecdotally TIA patients report ongoing impairments.
Aim: investigate the long term impact of TIA through the association between TIA and consultation for fatigue, psych and cog impairment in primary care.

2. What the Researchers Did
Design: Retrospective cohort study
Outcomes
Patients
Data source
Electronic medical records
TIA
Consultation for impairment
Controls
Matched 1:5
Age
Sex
General practice
Conducted a retrospective cohort study using anonymised electronic primary care records from the UK. Database covers over 500 general practices. TIA patients were matched 1:5 to controls on age, sex and general practice. Survival analysis compared time to consult for fatigue, psych and cog impairment between TIA patients and controls.

3. What the Researchers Found
TIA patients more likely to
consult for all 3 impairments
Adjused Hazard ratios
Fatigue: 1.43
Psychological impairment: 1.26
Cognitive impairment: 1.46
TIA patients
Controls
10,692
52,772
10,692 patients were matched to 52,772 controls. TIA patients had a statistically significant increased risk of consulting for all 3 impairments.

4. What This Means for Clinical Practice
Challenges the ‘transient’ definition of TIA
Current management of TIA may not be adequate
Impact on quality of life and stroke prevention
Future research
Mechanism
Identification of impairments
Treatment of impairments
Findings challenge the definition of TIA. Follow up is currently focused on stroke prevention but this may be inadequate. Ongoing impairments could impact on patients QoL and impair stroke prevention. Future research should investigate the mechanism of impairments after TIA and identify the best way to detect and treat impairments post-TIA.