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Influencing Factors Of Fatigue After Ischemic Stroke

Posted on:2024-09-12Degree:MasterType:Thesis
Country:ChinaCandidate:W L ZhangFull Text:PDF
GTID:2544306926990569Subject:Neurology
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Background:Post-stroke fatigue(PSF)occurs in more than one-third of stroke patients,hindering functional recovery after stroke and increasing the risk of death.At present,there is no well-established treatment for PSF,and controlling potentially modifiable risk factors is one of the treatment directions for PSF.Due to the complex pathogenesis of PSF,which involves numerous biological and psychosocial factors,there are still many controversies about the factors influencing the occurrence of PSF.This study aimed to establish an ischemic stroke cohort to evaluate the incidence and influencing factors of PSF in the acute phase and 3 months in the Chinese population,which would help deepen the understanding of PSF and provide a theoretical basis for reducing the incidence of PSF.Methods:Patients who were hospitalized in the Department of Neurology of the Guangdong Second Provincial General Hospital for ischemic stroke from August 2021 to September 2022 were enrolled consecutively.Demographic and general information,clinically relevant factors,stroke-related assessment,and laboratory index were collected at baseline after admission.Fatigue Severity Scale(FSS)was used to evaluate the acute phase fatigue level at 3 days after admission(when the condition was relatively stable),and followed up after 3 months.The outcome indicators were fatigue at acute phase and 3 months after ischemic stroke.FSS average score≥4 was divided into fatigue group;Otherwise,they were assigned to the non-fatigue group.The measurement data were expressed as median and interquartile ranges,and the Mann-Whitney U test was used to test the difference.The categorical variables were expressed as frequency and percentage,and the difference test was performed by Chi-square test or Fisher’s exact test.Appropriate independent variables were selected as candidate variables for multivariate Logistic regression analysis.The expected maximum method(EM algorithm)was used to fill in the missing values.The multivariate logistic regression was completed again with the filled data for sensitivity analysis.Bilateral P<0.05 indicated a statistically significant difference.Results:A total of 258 patients were enrolled consecutively,and 251 patients completed 3-month follow-up.The incidence of PSF was 38.4%in acute stage and 24.7%after 3 months,in which 14.0%of patients suffering from persistent fatigue in 3 months.Univariate analysis and multivariate Logistic regression analysis showed that the influencing factors of PSF in the acute phase were:first-episode stroke(OR=0.323,95%CI=0.159-0.655,P=0.002),gait abnormality(OR=2.844,95%CI=1.280-6.318,P=0.010)and resignation dimension score in medical coping modes(OR=1.382,95%CI=1.221-1.564,P<0.001).The factors influencing the occurrence of PSF at 3 months were as follows:acute phase PSF(OR=3.263,95%CI=1.678-6.348,P<0.001),depression(OR=4.738,95%CI=1.495-15.016,P=0.008),leukoencephalopathy(OR=1.629,95%CI=1.069-2.483,P=0.023),and good sleep(OR=0.335,95%CI=0.161-0.700,P=0.004).The influencing factors of PSF screening at the acute stage and 3 months after missing value filling were consistent with those before filling.Conclusions:(1)In this study,the incidence of PSF was 38.4%in acute phase and 24.7%after 3 months,in which 14.0%of patients suffering from persistent fatigue in 3 months.(2)First-episode stroke,gait abnormality,and resignation dimension score in medical coping modes correlated with acute phase PSF.(3)Acute phase PSF,depression,leukoencephalopathy,and sleep status were related to the occurrence of PSF after 3 months.
Keywords/Search Tags:Post-stroke fatigue, Morbidity, Influencing factors, Ischemic stroke
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