A latent transition analysis of longitudinal stability of post-stroke fatigue

Previous studies have confirmed the individual heterogeneity of post-stroke fatigue (PSF). However, the transition of PSF categories over time has not been thoroughly explored. The main purpose of this study was to identify the latent profiles of PSF during acute hospitalization (T1) and three months post-discharge (T2) and to describe the latent transition patterns among these profiles. The secondary objective was to identify factors potentially associated these transition patterns.

A prospective observational study was conducted between September 2022 and July 2023 in the neurology department of a general hospital in southeast China. Data collection occurred at T1 and T2, with 310 stroke patients completing follow-up. Data were gathered using the 10-item Connor-Davidson Resilience Scale and the Fatigue Severity Scale. Latent transition analysis was employed to examine the transition patterns of PSF from T1 to T2.

Three subgroups exhibiting varying degrees of fatigue were identified both at T1 and T2, designated respectively as the mild fatigue group, moderate fatigue group, and severe fatigue group. The longitudinal stability range for fatigue severity categories was between 29.3% and 65.2%. Approximately half (47.1%) of the stroke patients were classified into the stable group. However, 35.4% and 17.5% of the stroke patients were transitioned into the adaptation group and the aggravation group, respectively. NIHSS scores, number of comorbidities, and psychological resilience were factors potentially associated with the three derived transition patterns.

This study revealed three derived transition patterns of PSF within three months. Furthermore, the results offer an exploratory understanding of the factors potentially associated the derived transition patterns of PSF.