Analysis of Factors Affecting Post-Stroke Fatigue: An Observational, Cross-Sectional, Retrospective Chart Review Study.

Seungwon Kwon,Chang-Nam Ko,Seong-Uk Park,Seung-Yeon Cho,Sang-Kwan Moon,Chul Jin,Woo-Sang Jung,Jung-Mi Park,Ki-Ho Cho

doi:10.3390/healthcare9111586

Abstract

Post-stroke fatigue (PSF) is one of the most common emotional and mood disorders in stroke survivors. Several studies have suggested associations between PSF and various factors. However, they describe conflicting results. Therefore, this study aimed to evaluate the factors affecting PSF. We retrospectively reviewed the medical records of 178 hospitalized stroke patients. The collected data were compared between the PSF and control groups. To evaluate the association between factors and PSF, regression analysis was conducted. A total of 96 patients (53.9%) were assigned to the PSF group, and 82 patients were assigned to the control group. Age, neurological deficits, cognitive dysfunction, degree of depression, hs-CRP, and ESR differed significantly between the two groups. For both types of stroke, multiple linear regression analyses showed that degree of depression and degree of inflammation were significantly associated with PSF. Through subgroup analysis, multiple linear regression analyses showed that the degree of depression in ischemic and hemorrhagic stroke and the platelet-to-lymphocyte ratio in hemorrhagic stroke had a significant association with PSF. In conclusion, post-stroke depression and degree of inflammation could be clinically significant predictors of PSF in all types of stroke patients. However, larger, prospective studies are required to obtain more concrete results.

Highlights

Despite the improvements made in the survival rate of patients with stroke [1], these patients still experience physical disability, as well as cognitive, emotional, and behavioral disorders as sequelae [2], all of which significantly reduce the quality of life of survivors [2]
Statistical Analysis To investigate the differences in characteristics according to the presence or absence of Post-stroke fatigue (PSF), t-tests or Mann–Whitney U test were performed for continuous variables, and chi-squared tests were performed for categorical variables
The PSF and control groups showed no significant differences in terms of sex ratio, body mass index, and education period

Summary

Introduction

Despite the improvements made in the survival rate of patients with stroke [1], these patients still experience physical disability, as well as cognitive, emotional, and behavioral disorders as sequelae [2], all of which significantly reduce the quality of life of survivors [2]. With the recent improvements in the quality of life of survivors, the importance of managing emotional and mood disorders, which are non-physical disorders, has been highlighted [3]. Post-stroke emotional disorders encompass depression, anxiety, emotion control disorder, anger control disorder, and fatigue that occurs after a stroke [3]. Post-stroke fatigue (PSF) is one of the most common emotional disorders, and the previous studies suggested that 16%–85% of stroke patients experience PSF [4,5,6,7]. PSF was shown to lead to physical deconditioning and reduced self-efficacy in physical performance, poor participation, and outcomes in rehabilitation programs, reduced social participation, poor quality of life, functional limitations, and increased mortality [7,8]

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