title: Determinants of fatigue after first-ever ischemic stroke during acute phase.
abstract: OBJECTIVE
  Fatigue after stroke is common and has a negative impact on rehabilitation and survival. However, its pathogenesis and contributing factors remain unclear. The purpose of this study was to identify factors influencing the occurrence of fatigue after first-ever ischemic stroke in acute phase.
  
  
  METHODS
  We examined 265 consecutive patients with first-ever ischemic stroke during acute phase (within 2 weeks) in two tertiary stroke care hospitals in Henan, China. We documented patients' demographic and clinical characteristics through face-to-face interviews using structured questionnaires and reviews of medical records. Post-stroke fatigue was defined as a score of ≥4 using the Fatigue Severity Scale. Multivariate logistic regression was used to examine post-stroke fatigue in relation to socio-demographic, lifestyle, clinical characteristics and family function.
  
  
  RESULTS
  About 40% first-ever ischemic stroke patients experienced post-stroke fatigue in acute phase. Post-stroke fatigue was associated with lack of exercise before stroke (adjusted odds ratio 4.01, 95% CI 1.95-8.24), family dysfunction (2.63, 1.20-5.80), depression (2.39, 1.02-5.58), the presence of pre-stroke fatigue (4.89, 2.13-11.21), use of sedative medications (4.14, 1.58-10.88), coronary heart disease (3.38, 1.46-7.79) and more severe Modified Rankin Scale (2.55, 1.65-3.95).
  
  
  CONCLUSIONS
  The causes of post-stroke fatigue are multifaceted. More physical exercise, improving family function, reducing depression and appropriate use of sedative medications may be helpful in preventing post-stroke fatigue.
authors.affiliation: Institute of Public Health, School of Nursing, Henan University, Kaifeng, China.
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Wang
authors.affiliation: Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
authors.forename: Jia-Ji
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Institute of Public Health, School of Nursing, Henan University, Kaifeng, China; Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
authors.forename: Pei-Xi
authors.initials: PX
authors.lastname: Wang
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, London, United Kingdom; Centre for Health and Social Care Improvement (CHSCI), University of Wolverhampton, Wolverhampton, United Kingdom.
authors.forename: Ruoling
authors.initials: R
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000150:complications*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications*