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Fatigue after ischaemic stroke: A five-year longitudinal study of prevalence and latent trajectory subgroups
Kristin Haugskott Tiller1, Hild Fjærtoft1,2, Siw Tone Innstrand3
1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Abstract:
ObjectiveTo investigate the prevalence and longitudinal course of post-stroke fatigue and identify subgroups with distinct fatigue trajectories up to 5 years post-stroke.DesignA prospective, longitudinal, multi-centre cohort study.SettingHospital stroke units in the Central-Norway health region.ParticipantsIncident ischaemic stroke patients were recruited during acute hospitalisation between June 2015 and November 2017. Data were collected during the hospital stay and at 3 months, 1 year, 3 years, and 5 years.Main measuresFatigue was assessed using the 7-item Fatigue Severity Scale with >5 as cut-off to define clinical fatigue.ResultsA total of 693 participants were included. The prevalence of clinical fatigue was 24% (3 months), 28% (1 year), 30% (3 years), and 28% (5 years). A Sankey diagram illustrated substantial variability in fatigue status across time points. Using group-based trajectory modelling, four latent subgroups with distinct fatigue trajectories were identified: (1) low fatigue, (2) emerging fatigue, (3) improving fatigue, and (4) high fatigue.ConclusionOne quarter to one third of the study population consistently exhibited fatigue up to 5 years post-stroke. High variability in fatigue status over time was evident, indicating individual-level heterogeneity in the longitudinal course. This was further confirmed by the identification of four latent subgroups with distinct post-stroke fatigue trajectories. Early detection of individuals at risk of an adverse fatigue trajectory and differentiated follow-up may improve outcomes for stroke survivors.
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