Fatigue in the acute phase after first stroke predicts poorer physical health 18 months later

Abstract

Objective: To determine whether fatigue in the acute phase following stroke predicts long-term patient-reported physical and mental health outcomes 18 months later. Methods: Patients (n = 96, mean age 67.8 years, SD 12.9) were assessed within 2 weeks of hospital admission for first-ever stroke (acute phase) and 18 months later. Measures included the Fatigue Severity Scale and the Beck Depression Inventory II. The Short Form–36 was used to assess self-reported physical and mental health. Multivariate regression analysis was used to evaluate the relationship between acute phase fatigue and later health outcomes, controlling for relevant covariates. Results: Acute phase fatigue was associated with physical health at 18-month follow-up, but not with mental health. After adjusting for other potential predictors of health outcomes, including age, sex, cohabitation status, acute phase physical or mental health, and depressive symptoms, acute phase fatigue remained a significant predictor of later physical health but not of later mental health. The reverse relationships were also examined, but neither physical nor mental health in the acute phase predicted fatigue at 18 months; the best predictor of fatigue at 18-month follow-up was acute phase fatigue. Conclusions: These findings suggest that acute phase fatigue is an independent risk factor for poor physical health 18 months after stroke. Diagnosis and treatment of acute phase fatigue may improve physical health-related quality of life among stroke survivors. Effective treatments for poststroke fatigue, both in the acute phase and later in the recovery period, are needed. BDI-II= : Beck Depression Inventory version II; FSS= : Fatigue Severity Scale; HRQoL= : health-related quality of life; ICD-10 = : International Classification of Diseases, 10th revision; MCS= : Mental Component Summary; MMSE= : Mini-Mental State Examination; PCS= : Physical Component Summary; SF-36= : 36-item Short Form acute version; SSS= : Scandinavian Stroke Scale