Transient ischemic attacks (TIA), short episodes of decreased blood flow to the brain, carry a “not so benign” prognosis, according to a new report in the journal Stroke.

“TIAs are not the benign variant of stroke, but carry a rather high short-term risk for subsequent health impairment,” Dr. Michael Daffertshofer from University Heidelberg, Mannheim, Germany told AMN Health.

Daffertshofer and colleagues evaluated 1,380 patients hospitalized for TIA and 3,855 hospitalized for stroke. The researchers compared the two groups’ test results, length of hospital stay, in-hospital complications, and outcome at discharge and after six months.

During their hospital stay, eight percent of TIA patients had pneumonia or urinary tract infection (compared with 19 percent of stroke patients), the report indicates. Two percent of TIA patients had a cardiovascular event (versus four percent of stroke patients), and eight percent of TIA patients had a subsequent stroke during their hospital stay.

In-hospital mortality was two percent for TIA patients (nine percent for stroke patients), the researchers note, and five percent of TIA patients (versus 10 percent of stroke patients) died during the six months after they were first seen. Five percent of TIA patients had a stroke after discharge, compared with a six-percent recurrence rate among stroke patients.

Independent predictors of death or dependency for TIA patients after six months included age over 60 years, blood clot, and evidence of a heart attack.

“With this background, in our opinion, the acute diagnosis always has to be ‘brain attack,’” the investigators write, “and patients are to be evaluated immediately and similarly, whether the properly validated symptoms have been resolved early or not.”

SOURCE: Stroke, November 2004.