Acute-Phase Fatigue Predicts Limitations with Activities of Daily Living 18 Months after First-Ever Stroke
Acute-Phase Fatigue Predicts Limitations with Activities of Daily Living 18 Months after First-Ever Stroke
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DOI：
10.1016/j.jstrokecerebrovasdis.2016.11.130
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发表时间：
2017-03-01
影响因子：
2.5
通讯作者：
Gay, Caryl L.
中科院分区：
文献类型：
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作者：
Lerdal, Anners;Gay, Caryl L.
背景：中风后急性期的疲劳已被证明可以预测长期的身体健康状况，特别是身体疼痛的增加和自评总体健康状况较差。本分析的目的是确定急性期疲劳是否也可以预测患者首次中风后 18 个月日常生活活动 (ADL) 的限制。方法：在挪威 2 家医院入院时招募首次中风患者 (N = 88)。患者在入院后 2 周内和 18 个月时使用巴塞尔日常生活活动指数 (BI)、疲劳严重程度量表和贝克抑郁量表 II 进行评估。使用控制相关协变量和急性期 ADL 功能的多变量逻辑回归分析来评估急性期疲劳与后期活动限制 (BI < 20) 之间的关系。结果：即使在控制 ADL 功能的其他预测因素（包括年龄、性别、基线工作状态以及急性期抑郁症状和 ADL 功能）时，急性期疲劳与 18 个月随访时的活动限制相关（P = .002）。检查相反的关系，急性期活动受限与中风后 18 个月的疲劳无关。结论：我们的研究表明，急性期疲劳可能是卒中后 18 个月活动受限的独立危险因素。这一发现表明，在急性期和恢复期后期对中风后疲劳进行有效治疗可能有助于更好的中风康复。
Background: Fatigue during the acute phase following stroke has been shown to predict long-term physical health, specifically increased bodily pain and poorer self-rated general health. The aim of this analysis was to determine whether acute-phase fatigue also predicts patients' limitations in activities of daily living (ADL) 18 months after the first stroke. Methods: Patients with first-ever stroke (N = 88) were recruited upon admission at 2 hospitals in Norway. Patients were assessed within 2 weeks following admission and at 18 months using the Barthel Index of Activities of Daily Living (BI), Fatigue Severity Scale, and Beck Depression Inventory II. The relationship between acute-phase fatigue and later activity limitations (BI < 20) was evaluated using multivariate logistic regression analysis controlling for relevant covariates and acute-phase ADL function. Results: Acute-phase fatigue was associated with activity limitations at 18-month follow-up (P = .002), even when controlling for other predictors of ADL function, including age, gender, baseline work status, and acute-phase depressive symptoms and ADL function. Examining the reverse relationship, acute-phase activity limitations were unrelated to fatigue 18 months after stroke. Conclusion: Our study indicates that acute-phase fatigue may be an independent risk factor for activity limitations 18 months after stroke. This finding suggests that effective treatments for poststroke fatigue both in the acute phase and later in the recovery period may contribute to better stroke rehabilitation.