The Impact of Tilburg Frailty on Poststroke Fatigue in First-Ever Stroke Patients: A Cross-Sectional Study With Unified Measurement Tools and Improved Statistics.

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Annals of Clinical and Translational Neurology Pub Date : 2025-10-22 DOI:10.1002/acn3.70202

Chuan-Bang Chen, Xiao-Xue Wang, Shao-Rui Bao, Sui-Li Lin, Mei-Chun Shu, Xi-Xi Ye, Wen-Jie Cong

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引用次数: 0

Abstract

Background: Poststroke fatigue (PSF) and frailty share substantial overlap in their manifestations, yet previous research has yielded conflicting results due to the use of heterogeneous frailty assessment tools.

Objective: To evaluate the independent impact of frailty on PSF using a unified measurement system (Tilburg Frailty Indicator, TFI) while controlling for modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), anxiety, depression, and other confounding factors.

Methods: A single-center cross-sectional study was conducted with 320 first-ever stroke patients. Frailty was assessed using the TFI, fatigue with the Fatigue Severity Scale (FSS), and psychological symptoms with the Hospital Anxiety and Depression Scale (HADS). Both linear regression and logistic regression models were employed, with quantile regression for robustness testing.

Results: TFI total score demonstrated a strong positive correlation with FSS scores (ρ = 0.85, p < 0.001). Here, frailty (independent variable) was captured by TFI and poststroke fatigue (dependent variable) by FSS. In multivariable regression analysis, TFI (β = 0.42, 95% CI: 0.35-0.49), HADS-A (β = 0.28, 95% CI: 0.21-0.35), and NIHSS (β = 0.18, 95% CI: 0.11-0.25) emerged as significant predictors of PSF (all p < 0.001). The combined model explained 74.2% of variance in fatigue scores.

Conclusion: The use of the unified frailty assessment tool (TFI) resolves previous conflicting findings and confirms that frailty is a strong independent predictor of PSF. Routine frailty assessment using the TFI should be incorporated into poststroke care to identify patients at high risk for fatigue and guide targeted interventions.

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蒂尔堡衰弱对首次中风患者脑卒中后疲劳的影响：一项采用统一测量工具和改进统计的横断面研究。

背景：卒中后疲劳（PSF）和虚弱在其表现上有大量重叠，但由于使用了不同的虚弱评估工具，先前的研究得出了相互矛盾的结果。目的：在控制改良Rankin量表（mRS）、美国国立卫生研究院卒中量表（NIHSS）、焦虑、抑郁等混杂因素的情况下，采用统一的测量系统（Tilburg虚弱指标，TFI）评估虚弱对PSF的独立影响。方法：对320例首次脑卒中患者进行单中心横断面研究。使用TFI评估虚弱，使用疲劳严重程度量表（FSS）评估疲劳，使用医院焦虑和抑郁量表（HADS）评估心理症状。采用线性回归和逻辑回归模型，采用分位数回归进行稳健性检验。结果：TFI总分与FSS评分呈强正相关（ρ = 0.85, p）。结论：使用统一的衰弱评估工具（TFI）解决了之前的矛盾发现，并证实衰弱是PSF的一个强有力的独立预测因子。使用TFI的常规虚弱评估应纳入卒中后护理，以识别疲劳高风险患者并指导有针对性的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.