Alghamdi Ibraheem, Ariti Cono, Williams Adam, Wood Emma, Hewitt Jonathan
Department of Family and Community Medicine, School of Medicine, King Saud University, Riyadh, Saudi Arabia.
Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK.
Eur Stroke J. 2021 Dec;6(4):319-332. doi: 10.1177/23969873211047681. Epub 2021 Oct 7.
Post-stroke fatigue is a debilitating and long-lasting condition. However, there are uncertainties regarding its prevalence and variability between studies. This review aims to estimate the prevalence of fatigue and determine the factors responsible for its variation in the literature.
A systematic review was conducted for all published studies (search to November 2020) using AMED, CINAHL, EMBASE, MEDLINE, PsycINFO, SCOPUS and Web of Science. Papers were included if they recruited participants with stroke, used a validated scale to measure fatigue and were in English. Two reviewers screened and assessed the relevant studies for eligibility ( = 96). The included papers were appraised using the Joanna Briggs Institute (JBI) tool for prevalence studies, and data were extracted by one reviewer. To understand the variation in PSF prevalence between papers, data were pooled and analysed based on relevant methodological (e.g. time of assessment) or clinical factors (e.g. depression) using Review Manager 5.4 software.
While 48 studies were included and summarised ( = 9004), only 35 were appropriate for the meta-analysis ( = 6851). The most frequently used tool to measure fatigue was the Fatigue Severity Scale (FSS) ( = 31). The prevalence was calculated with a cut-off point of four or more using FSS and resulted in an estimate of 48% (95% CI 42-53%). Time of assessment (<6 vs ≥6 months), stroke type (ischaemic vs haemorrhagic/subarachnoid haemorrhage) and geographical location (East Asia vs Europe) could explain the prevalence variation between studies.
Fatigue is prevalent among stroke survivors. This condition varies in terms of occurrence between studies; however, time of assessment, stroke type and geographical location might explain this variation. As this review estimates the overall burden of fatigue after stroke, it provides a useful indicator to inform policy, planning and healthcare professionals. Further efforts are required to investigate the mechanisms that lead to PSF, particularly in the groups that show high prevalence, in order to prevent or alleviate it.
中风后疲劳是一种使人虚弱且持续时间长的病症。然而，关于其在不同研究中的患病率及变异性仍存在不确定性。本综述旨在估计疲劳的患病率，并确定文献中导致其变异的因素。
使用AMED、CINAHL、EMBASE、MEDLINE、PsycINFO、SCOPUS和Web of Science对所有已发表的研究（检索至2020年11月）进行系统综述。如果研究招募了中风患者、使用经过验证的量表来测量疲劳且为英文，则纳入该论文。两名评审员筛选并评估相关研究的 eligibility（=96）。使用乔安娜·布里格斯研究所（JBI）的患病率研究工具对纳入的论文进行评价，由一名评审员提取数据。为了解各论文之间中风后疲劳患病率的差异，使用Review Manager 5.4软件，基于相关方法学（如评估时间）或临床因素（如抑郁）对数据进行汇总和分析。
虽然纳入并总结了48项研究（=9004），但只有35项适合进行荟萃分析（=6851）。测量疲劳最常用的工具是疲劳严重程度量表（FSS）（=31）。使用FSS以四分及以上作为临界值计算患病率，得出估计值为48%（95%CI 42 - 53%）。评估时间（<6个月与≥6个月）、中风类型（缺血性与出血性/蛛网膜下腔出血）和地理位置（东亚与欧洲）可以解释不同研究之间患病率的差异。
疲劳在中风幸存者中很普遍。这种情况在不同研究中的发生率有所不同；然而，评估时间、中风类型和地理位置可能解释了这种差异。由于本综述估计了中风后疲劳的总体负担，它为政策制定、规划和医疗保健专业人员提供了一个有用的指标。需要进一步努力研究导致中风后疲劳的机制，特别是在患病率高的群体中，以便预防或减轻这种情况。
