Evaluating the complaint of fatigue in primary care: diagnoses and outcomes.
OBJECTIVE
This case series describes associated diagnoses and prognoses of persistent fatigue in a community-based, primary care population.


METHODS
All patients presenting to a private practice internist with a chief complaint of fatigue of more than 1 month's duration were prospectively evaluated with clinically directed examination and diagnostic testing. Patients were excluded if they had a previously diagnosed illness associated with fatigue. Fatigue was attributed to newly established diagnoses or medication use based on explicit criteria. Change in the state of each patient's fatigue was measured 6 months after entry.


RESULTS
Fifty-two consecutive patients entered the study. The diagnoses associated with fatigue were a medical disorder in 25 patients, depression in 10 patients, and no definitive diagnosis in 18 patients. The mean cost of diagnostic testing was $131. At 6 months, 37 of 52 patients (72%) reported improvement in or resolution of their fatigue.


CONCLUSIONS
In a primary care setting, many patients presenting with persistent fatigue have an associated, treatable disease that can be determined using a cost-effective, clinically directed approach. Most will experience an improvement in their fatigue.
Elnicki
D M
DM
Section of General Internal Medicine, West Virginia University School of Medicine, Morgantown 26506.
Shockcor
W T
WT
Brick
J E
JE
Beynon
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D005194:Family Practice; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies