Prevalence Of Post-stroke Fatigue After Ischemic Stroke And Research For Its Influencing Factors

Objective To investigate the incidence of post-stroke fatigue in two weeks,1^th month,3^th month,6^th month after ischemic stroke,to understand the change trend of post-stroke fatigue,and analyze influencing factors of post-stroke fatigue in different periods,providing theoretical basis for the further targeted intervention according to the influencing factors at different time to alleviate fatigue.Methods A investigative design was used in the study.440 hospitalized ischemic stroke patients in department of neurology in the first affiliated hospital of Zhengzhou university were recruited from October 2015 to May 2016 according to the inclusion and exclusion criteria.Baseline survey was completed in 2 weeks after stroke,including demographic data,fatigue prevalence and clinical related influencing factors?the severity of disease,blood biochemical indexes,pain,post-stroke depression,sleep quality,coping styles,etc.?Exploring influencing factors of post-stroke fatigue by subjective information,scale score and objective testing index.The following data of patients were investigated respectively at 1^th,3^th month,6^th month after stroke,including fatigue prevalence,MRS score,pain,post-stroke depression,sleep quality and the coping style score.Data were analyzed applying statistical software SPSS17.0.The mean ± standard deviation,frequency,percentage for data statistical description;Using Chi-square test,Kruskal-Wallis non-parametric test,and the two dependent sample T test conducted single factor analysis;Logistic regression analysis was used for influencing factors analysis of fatigue,P < 0.05 was statistically significant.Results1 440 ischemic stroke patients were included in this study,average age was 62.43±12.09 years old,men accounted for 59.5%,married accounted for 91.1%.Patients admitted to hospital after mild cerebral ischemic?NIHSS score ? 3?accounted for 62.9%,no obvious disabled?MRS<2?accounted for 33.9%,the average admission blood glucose was?6.08±1.51?mmol/L.After six months of follow-up,losing 27,the rate of lost to follow-up was 6.14%;mortality with 11 died was 2.50%;the recurrence rate with 23 relapsed was 5.23%.2 The fatigue score of patients was 3.53±1.57,3.61±1.44,3.59±1.51,3.57±1.48 in two weeks,1^th month,3^th month,6^th month after stroke respectively,the incidence of post-stroke fatigue were 36.8%,37.7%,33.3% and 30.6% respectively,which showed a trend of gradual decline over time.3 The influence factors of post-stroke fatigue3.1 Sex?OR=0.543,95%CI=0.326⁰.905?,exercise before stroke?OR=0.470,95%CI=0.287⁰.769?,pre-stroke fatigue?OR=3.173,95%CI=1.652⁶.094?,MRS score?OR=2.481,95%CI=1.475 4.171?,post-stroke depression?OR=2.383,95%CI=1.445³.929?and blood glucose?OR=1.231,95%CI=1.040¹.458?were influencing factors of post-stroke fatigue in two weeks after stroke.3.2 The influencing factors of post-stroke fatigue at 1^th month after stroke were place of residence?OR=0.455,95%CI=0.278 0.744?,exercise before stroke?OR=0.574,95%CI=0.354⁰.933?,pre-stroke fatigue?OR=2.926 95%CI=1.544⁵.545?,MRS score?OR=2.483,95%CI=1.506⁴.094?,post-stroke depression?OR= 2.846,95%CI=1.748⁴.635?.3.3 The influencing factors of post-stroke fatigue at 3^th month after stroke were pre-stroke fatigue?OR=2.723,95%CI=1.435 5.167?,MRS score?OR=2.511,95%CI=1.519 4.149?,pain?OR=2.738,95%CI=1.296 5.791?,post-stroke depression?OR=2.749,95%CI= 1.678⁴.503?.3.4 At 6^th month after stroke,pre-stroke fatigue?OR=2.405,95%CI=1.261⁴.588?,MRS score?OR=2.162,95%CI=1.317³.550?,pain?OR=2.656,95%CI= 1.204⁵.859?,post-stroke depression?OR=3.141,95%CI=1.885⁵.236?,negative coping style score?OR=1.790,95%CI=1.144².800?were influencing factors of post-stroke fatigue.Conclusions1 The incidence of post-stroke fatigue in 2 weeks,1^th month,3^th month,6^th month after ischemic stroke present a trend to decrease over time.2 Exercise before stroke is a protective factor of post-stroke fatigue in 2 weeks and 1^th month after ischemic stroke.High blood glucose is a risk factor of post-stroke fatigue in 2 weeks after stroke.Moderate or above degree of pain is a risk factor of post-stroke fatigue at 3^th month,6^th month after stroke.Negative coping style score is a risk factor of post-stroke fatigue at 6^th month after stroke,suggest that improving coping style may be a new direction in the management of post-stroke fatigue.Pre-stroke fatigue,post-stroke depression and obvious disability are common risk factors of post-stroke fatigue at four times points,indicating this three risk factors persist in six months after stroke,suggest medical staff should encourage patients as soon as possible to treat related diseases of pre-stroke fatigue,to improve the mental health and promote function recovery.