Abstract
Background and Purpose
Poststroke fatigue (PSF) is rife among stroke survivors and it exerts a detrimental
toll on recovery from functional deficits. The burden of PSF is unknown in sub-Saharan
Africa. We have assessed the prevalence, trajectory, and predictors of PSF among 60
recent Ghanaian stroke patients.
Methods
Study participants in this prospective cohort (recruited between January 2017 and
June 2017) were stroke survivors, aged greater than 18 years, with CT scan confirmed
stroke of less than 1-month onset. PSF was assessed using the Fatigue Severity Scale
(FSS) at enrollment, months 3, 6, and 9. Those with a score of greater than or equal
to 4 points on FSS were categorized as “fatigued.” A multivariate logistic regression
analysis was performed to identify independent predictors of PSF at enrollment and
at month 9.
Results
Sixty-five percent (65%) of our sample were males with a mean age of 55.1 ± 12.7 years.
In addition to all participants having hypertension, 85% had dyslipidemia and 25%
had diabetes mellitus. Ischemic strokes comprised 76.6% of the study population. The
prevalence of PSF was 58.9% at baseline and declined to 23.6% at month 9, P = .0002. Diabetes mellitus was significantly associated with PSF at baseline with
an adjusted odds ratio of 15.12 (95% CI: 1.70-134.30), P = .01. However, at month 9, age greater than or equal to 65 years, adjusted odds
ratio (aOR) of 7.02 (95% CI: 1.16-42.52); female sex, aOR of 8.52 (1.23-59.16), and
depression, aOR of 8.86 (1.19-65.88) were independently associated with PSF.
Conclusions
Approximately 6 out of 10 Ghanaian stroke survivors experience PSF within the first
month of stroke onset. PSF persists in approximately 1 out of 4 stroke survivors at
10 months after the index stroke. Further studies to elucidate the underlying mechanisms
for PSF are required and adequately powered interventional multicenter trials are
eagerly awaited to provide solid evidence base for the clinical management of PSF.
Key Words
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Article info
Publication history
Published online: February 20, 2019
Accepted:
February 4,
2019
Received in revised form:
January 30,
2019
Received:
September 24,
2018
Footnotes
Financial Disclosure: National Institute of Neurological Disorders & Stroke; R21 NS094033.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.02.002
Copyright
© 2019 Elsevier Inc. All rights reserved.
