Institute of Biomedicine, Department of Laboratory Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Clinical Genetics and Genomics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Neurol Scand. 2022 Sep;146(3):295-303. doi: 10.1111/ane.13665. Epub 2022 Jul 5.
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.
中风后疲劳（PSF）很常见，对生活质量有很大影响。我们探讨了缺血性中风后长期的预测和横断面相关特征。
本研究包括前瞻性萨赫勒格伦斯卡学院缺血性中风研究（SAHLSIS）的 430 名参与者，在指数中风时年龄为 18-69 岁。在指数中风时收集了急性中风严重程度和心血管危险因素的信息。7 年后，使用每日疲劳影响量表（D-FIS）评估 PSF。还评估了认知、神经和功能结局，以及抑郁和焦虑、疼痛、失眠和身体活动的症状。通过有序回归分析基线变量与 PSF 之间的关联。使用 Spearman 或点二项式相关分析对整个样本和性别分层分析中 PSF 与横断面评估变量之间的相关性以及 PSF 与基线变量之间的相关性。
中风后 7 年，80%的参与者报告疲劳有一定影响。女性性别和中风严重程度与 PSF 独立相关，而与基线心血管危险因素无关。在 7 年的横断面分析中，我们发现 PSF 与较差的功能、神经和认知结局以及抑郁症状、焦虑、失眠、疼痛和低身体活动相关（p<.001 始终）。PSF 与失眠的相关性在女性中比男性更强（双向方差分析交互检验，p=0.03）。
我们的研究结果证实，PSF 在缺血性中风后长期内很常见，并且与性别和其他一些结局之间存在复杂的相互作用。未来的研究应该针对疲劳和共存特征的因果关系和干预措施。
