Fatigue 7 years post-stroke: Predictors and correlated features.
cerebral infarction
fatigue
follow-up studies
prognosis
stroke
Journal
Acta neurologica Scandinavica
ISSN: 1600-0404
Titre abrégé: Acta Neurol Scand
Pays: Denmark
ID NLM: 0370336
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
revised:
08
06
2022
received:
02
02
2022
accepted:
14
06
2022
pubmed:
6
7
2022
medline:
5
8
2022
entrez:
5
7
2022
Statut:
ppublish
Résumé
Post-stroke fatigue (PSF) is common with great impact on quality of life. We explored predictive and cross-sectionally correlated features in the long term after ischemic stroke. This study comprises 430 participants of the prospective Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), aged 18-69 years at index stroke. Information on acute stroke severity and cardiovascular risk factors was collected at index stroke. After 7 years, PSF was assessed by the Daily Fatigue Impact Scale (D-FIS). Cognitive, neurological, and functional outcomes, and symptoms of depression and anxiety, pain, insomnia, and physical activity were also assessed. Associations between baseline variables and PSF were analyzed by ordinal regression. Correlations between PSF and cross-sectionally assessed variables, and between PSF and baseline variables, were analyzed with Spearman's or point-biserial correlation for the whole sample and in sex-stratified analyses. At 7 years post-stroke, 80% of the participants reported some impact of fatigue. Female sex and stroke severity were independently associated with PSF, whereas no associations were detected with baseline cardiovascular risk factors. In cross-sectional analyses at 7 years, we found correlations between PSF and poor functional, neurological, and cognitive outcomes, as well as depressive symptoms, anxiety, insomnia, pain, and low physical activity (p < .001 throughout). The correlation with insomnia was stronger in women than in men (two-way ANOVA interaction test, p = .03). Our findings confirm that PSF is common in the long term after ischemic stroke and show a complex interplay with sex and several other outcomes. Future studies should address causal relationships and interventions towards fatigue and coexisting features.
Sections du résumé
BACKGROUND
BACKGROUND
Post-stroke fatigue (PSF) is common with great impact on quality of life. We explored predictive and cross-sectionally correlated features in the long term after ischemic stroke.
METHODS
METHODS
This study comprises 430 participants of the prospective Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), aged 18-69 years at index stroke. Information on acute stroke severity and cardiovascular risk factors was collected at index stroke. After 7 years, PSF was assessed by the Daily Fatigue Impact Scale (D-FIS). Cognitive, neurological, and functional outcomes, and symptoms of depression and anxiety, pain, insomnia, and physical activity were also assessed. Associations between baseline variables and PSF were analyzed by ordinal regression. Correlations between PSF and cross-sectionally assessed variables, and between PSF and baseline variables, were analyzed with Spearman's or point-biserial correlation for the whole sample and in sex-stratified analyses.
RESULTS
RESULTS
At 7 years post-stroke, 80% of the participants reported some impact of fatigue. Female sex and stroke severity were independently associated with PSF, whereas no associations were detected with baseline cardiovascular risk factors. In cross-sectional analyses at 7 years, we found correlations between PSF and poor functional, neurological, and cognitive outcomes, as well as depressive symptoms, anxiety, insomnia, pain, and low physical activity (p < .001 throughout). The correlation with insomnia was stronger in women than in men (two-way ANOVA interaction test, p = .03).
CONCLUSIONS
CONCLUSIONS
Our findings confirm that PSF is common in the long term after ischemic stroke and show a complex interplay with sex and several other outcomes. Future studies should address causal relationships and interventions towards fatigue and coexisting features.
Identifiants
pubmed: 35791041
doi: 10.1111/ane.13665
pmc: PMC9545687
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
295-303Subventions
Organisme : Swedish Heart and Lung Foundation
ID : 20190203
Organisme : Swedish State under the agreement between the Swedish Government and the County Councils, the ALF-agreement
ID : ALFGBG-965328
Organisme : Swedish Research Council
ID : 2021-01114
Organisme : Swedish Stroke Association
Organisme : King Gustaf V:s and Queen Victoria's Freemasons' Foundation
Organisme : Gothenburg Foundation for Neurological Research
Informations de copyright
© 2022 The Authors. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.
Références
Stroke. 2012 Oct;43(10):2604-9
pubmed: 22851549
Clin Infect Dis. 1994 Jan;18 Suppl 1:S79-83
pubmed: 8148458
Sleep. 2006 Jan;29(1):85-93
pubmed: 16453985
J Neurol Sci. 2012 Jan 15;312(1-2):138-41
pubmed: 21862037
J Neurol. 2019 Nov;266(11):2796-2806
pubmed: 31375988
Pilot Feasibility Stud. 2020 Jun 15;6:84
pubmed: 32549995
Clin Rehabil. 2017 Oct;31(10):1406-1415
pubmed: 28933604
Stroke. 2015 Mar;46(3):893-8
pubmed: 25649798
Sci Rep. 2018 May 21;8(1):7900
pubmed: 29785009
Acta Neurol Scand. 2022 Sep;146(3):295-303
pubmed: 35791041
Top Stroke Rehabil. 2015 Jun;22(3):208-20
pubmed: 25779764
Thromb Haemost. 2016 Aug 30;116(3):537-43
pubmed: 27357914
Scand J Med Sci Sports. 2015 Dec;25 Suppl 4:119-25
pubmed: 26589125
Acta Neurol Scand. 2012 Apr;125(4):248-53
pubmed: 21692753
Circulation. 1968 Dec;38(6):1104-15
pubmed: 5721960
Acta Neurol Scand. 2017 Apr;135(4):419-425
pubmed: 27265610
J Health Psychol. 2016 Dec;21(12):2863-2871
pubmed: 26124087
J Neurol Neurosurg Psychiatry. 2015 Oct;86(10):1120-6
pubmed: 25362090
PLoS One. 2016 Aug 30;11(8):e0161942
pubmed: 27575043
Stroke Res Treat. 2015;2015:347920
pubmed: 26101691
Neuropsychol Rehabil. 2020 Sep;30(8):1449-1476
pubmed: 30905262
BMC Neurol. 2016 May 27;16:80
pubmed: 27411309
Int J Stroke. 2014 Apr;9(3):313-20
pubmed: 23227818
J Stroke Cerebrovasc Dis. 2009 Nov-Dec;18(6):466-8
pubmed: 19900650
J Psychosom Res. 2002 Feb;52(2):69-77
pubmed: 11832252
J Stroke Cerebrovasc Dis. 2014 Feb;23(2):349-55
pubmed: 23721621
JAMA. 2013 Feb 20;309(7):706-16
pubmed: 23423416
Arch Phys Med Rehabil. 1999 Feb;80(2):173-8
pubmed: 10025492
Stroke. 2006 May;37(5):1232-6
pubmed: 16601213
Am J Ind Med. 2020 Feb;63(2):170-179
pubmed: 31722121
Stroke. 2017 Jul;48(7):e159-e170
pubmed: 28546322
Stroke. 2012 Apr;43(4):1046-51
pubmed: 22308241
Acta Neurol Scand. 2015 Jun;131(6):400-4
pubmed: 25307789
Qual Life Res. 2002 May;11(3):263-72
pubmed: 12074263
Stroke. 2012 Sep;43(9):2278-82
pubmed: 22744645
Stroke. 2005 Jul;36(7):1383-7
pubmed: 15933254
Clin Neurol Neurosurg. 2018 Nov;174:192-197
pubmed: 30266010
Stroke. 2015 Apr;46(4):1052-8
pubmed: 25677595
PLoS One. 2021 Aug 4;16(8):e0255538
pubmed: 34347804
Int J Stroke. 2016 Dec;11(9):968-977
pubmed: 27703065
J Clin Epidemiol. 1998 Nov;51(11):1105-13
pubmed: 9817128
J Neurol. 2010 Sep;257(9):1446-52
pubmed: 20352249
Int J Stroke. 2015 Jun;10(4):506-12
pubmed: 25472471
Int J Stroke. 2012 Feb;7(2):157-62
pubmed: 22264369
Neurol Sci. 2021 Apr;42(4):1463-1471
pubmed: 32813167
J Stroke Cerebrovasc Dis. 2018 Aug;27(8):2192-2199
pubmed: 29724611