Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
Arch Phys Med Rehabil. 2011 Aug;92(8):1336-8. doi: 10.1016/j.apmr.2011.02.018.
To evaluate the relationship between poststroke fatigue and suicidality (SI) in Chinese patients with first or recurrent stroke.
Cross-sectional survey.
Acute stroke unit of a general hospital.
Patients with acute ischemic stroke (N=595) admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong.
Not applicable.
SI was assessed with the Geriatric Mental State Examination at 3 months after the subjects' index stroke. Fatigue was evaluated using the Fatigue Severity Scale (FSS). The association between the mean FSS score and SI was examined and adjusted for potential confounders, including age, sex, marital status, previous stroke, depression, Mini-Mental State Examination score, and neurologic deficits in terms of the National Institutes of Health Stroke Scale score.
Seventy-six (12.8%) of the patients had SI (the SI group). The FSS score was significantly higher in the SI group (4.0±1.4 vs 2.8±1.2). The FSS score remained a significant predictor of SI in the subsequent forward logistic regression (odds ratio=1.5), adjusting for the possible confounders.
These findings should alert clinicians that early identification and treatment of fatigue may reduce the suicidal risk in stroke patients.
评估中国首发或复发性卒中患者卒中后疲劳与自杀意念（SI）之间的关系。
横断面调查。
综合医院急性卒中病房。
香港一所大学附属医院急性卒中病房收治的急性缺血性卒中患者（N=595）。
无。
在患者首发卒中后 3 个月，采用老年精神状态检查评估 SI。使用疲劳严重程度量表（FSS）评估疲劳。在调整了年龄、性别、婚姻状况、既往卒中、抑郁、简易精神状态检查评分和 NIH 卒中量表评分所代表的神经功能缺损等潜在混杂因素后，分析 FSS 评分均值与 SI 之间的相关性。
76 例（12.8%）患者存在 SI（SI 组）。SI 组的 FSS 评分显著较高（4.0±1.4 比 2.8±1.2）。在随后的向前逐步逻辑回归中，FSS 评分仍为 SI 的显著预测因素（优势比=1.5），调整了可能的混杂因素。
这些发现提示临床医生，早期识别和治疗疲劳可能降低卒中患者的自杀风险。
