Guangxi University of Chinese Medicine, Nanning, Guangxi, China.
Henan Vocational University of Science and Technology, Zhoukou, Henan, China.
Medicine (Baltimore). 2024 Oct 4;103(40):e39991. doi: 10.1097/MD.0000000000039991.
Almost half of ischemic stroke (IS) survivors have poststroke fatigue (PSF) during rehabilitation, which can reduce their rehabilitation compliance and quality of life. The primary link of PSF management is early identification, which can guide bundle of care for prevention. This study aimed to explore the predictive value of serological indicators for guiding bundle of care to prevent the occurrence of PSF among IS survivors. This study was a prospective observational study. A total of 350 patients with IS who were hospitalized in 2 tertiary hospitals in Nanning from October 2022 to September 2023 were selected. The general data of patients and serological indicators within 24 hours of admission were collected. Based on the follow-up results, the patients were divided into the PSF group and the NPSF group. Multivariate logistic regression analysis was used to screen the risk factors affecting the occurrence of PSF, and the receiver operating characteristic curve (ROC curve) method was used to analyze the predictive value of this factor. The incidence of acute-phase PSF among elderly patients with IS was 49.26%. The elevated levels of fasting plasma glucose (FPG) (OR = 1.485, 95% CI: 1.145-1.925, P = .003), total cholesterol (TC) (OR = 1.394, 95% CI: 1.013-1.917, P = .041), C-reactive protein (CRP) (OR = 1.394, 95% CI: 1.013-1.917, P = .041), and homocysteine (Hcy) (OR = 1.370, 95% CI: 1.233-1.524, P < .001) were risk factors of PSF in elderly patients with acute IS (P < .05). FPG (area under the curve = 0.632), TC (area under the curve = 0.621), CRP (area under the curve = 0.889), and Hcy (area under the curve = 0.807) had a good predictive value for acute-phase PSF, and the combination of the 4 indicators could further improve the predictive efficacy (area under the curve = 0.938, sensitivity 86.2%, specificity 90.7%, P < .05). The elevated levels of FPG, TC, CRP, and Hcy could predict the risk of PSF, and the combination of the 4 indicators can effectively improve prediction efficiency and provide a reference for guiding the formulation of bundle nursing programs.
近一半的缺血性脑卒中（IS）幸存者在康复期间存在卒中后疲劳（PSF），这会降低他们的康复依从性和生活质量。PSF 管理的首要环节是早期识别，这可以指导预防的护理方案。本研究旨在探讨血清学指标对指导护理方案预防 IS 幸存者 PSF 发生的预测价值。本研究为前瞻性观察性研究。选取 2022 年 10 月至 2023 年 9 月在南宁市 2 家三级医院住院的 350 例 IS 患者，收集患者入院 24 小时内的一般资料和血清学指标。根据随访结果，将患者分为 PSF 组和 NPSF 组。采用多变量 logistic 回归分析筛选影响 PSF 发生的危险因素，采用受试者工作特征曲线（ROC 曲线）分析该因素的预测价值。老年 IS 患者急性期 PSF 的发生率为 49.26%。空腹血糖（FPG）（OR=1.485，95%CI：1.145-1.925，P=0.003）、总胆固醇（TC）（OR=1.394，95%CI：1.013-1.917，P=0.041）、C 反应蛋白（CRP）（OR=1.394，95%CI：1.013-1.917，P=0.041）和同型半胱氨酸（Hcy）（OR=1.370，95%CI：1.233-1.524，P<0.001）升高是老年急性 IS 患者 PSF 的危险因素（P<0.05）。FPG（曲线下面积=0.632）、TC（曲线下面积=0.621）、CRP（曲线下面积=0.889）和 Hcy（曲线下面积=0.807）对急性期 PSF 具有良好的预测价值，4 项指标联合应用可进一步提高预测效能（曲线下面积=0.938，灵敏度 86.2%，特异度 90.7%，P<0.05）。FPG、TC、CRP 和 Hcy 水平升高可预测 PSF 风险，4 项指标联合应用可有效提高预测效能，为指导制定护理方案提供参考。
