Prevalence and Determinants of Poststroke Fatigue in Patients Treated With Acute Revascularization Therapy

IF 1.1 3区 医学 Q2 CLINICAL NEUROLOGY
Ramen Munir Baloch, Yannick Béjot
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Abstract

Objectives

Fatigue adversely affects quality of life after stroke. This study is aimed at assessing the prevalence of poststroke fatigue at 6 months and its determinants in patients with acute ischemic stroke treated with revascularization therapy.

Methods

Consecutive ischemic stroke patients treated with intravenous thrombolysis and/or mechanical thrombectomy were enrolled. Sociodemographic, clinical, and ischemic lesion characteristics were collected at baseline. Fatigue was assessed at 6-month follow-up using the Fatigue Severity Scale (FSS), along with functional outcome, anxiety, and depression. Factors associated with poststroke fatigue were evaluated in the overall cohort and in patients with supratentorial hemispheric stroke using logistic regression models.

Results

Among 900 enrolled patients, 413 survivors had available fatigue assessment (mean age: 69.2 ± 14.1 years, 52.3% men, median NIHSS score: 9 [IQR: 5–15]). Poststroke fatigue (FSS score ≥ 36) was observed in 161 patients (39%). In the overall cohort, fatigue was independently associated with depression (OR = 5.78, 95% CI: 2.68–12.4) and anxiety (OR = 2.90, 95% CI: 1.52–5.51), whereas being single was negatively associated with fatigue (OR = 0.30, 95% CI: 0.09–0.99). A marginal association was observed with cerebellar stroke location (OR = 11.0, 95% CI: 0.88–137.6). In patients with supratentorial hemispheric stroke, fatigue was independently associated with hypertension (OR = 2.25, 95% CI: 1.13–4.47), right-sided lesion (OR = 2.08, 95% CI: 1.13–3.83), depression (OR = 5.35, 95% CI: 2.08–13.7), and anxiety (OR = 3.10, 95% CI: 1.42–6.74).

Conclusions

Poststroke fatigue remains a frequent and clinically meaningful outcome in patients with ischemic stroke treated with revascularization therapy and is strongly associated with psychological factors and right hemispheric location. Whether specific therapeutic interventions may reduce the burden of this symptom warrants further investigation.

Trial Registration

ClinicalTrials.gov identifier: NCT02856074

急性血运重建治疗患者卒中后疲劳的患病率和决定因素
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来源期刊
Acta Neurologica Scandinavica
Acta Neurologica Scandinavica 医学-临床神经学
CiteScore
6.70
自引率
2.90%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.
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