Trajectories of post-stroke fatigue and its influencing factors in young and middle-aged patients with intracerebral hemorrhage.

Authors

Hui Qiu, Lixia Du, Xiaopeng Shi, Yanwei Cheng, Lijun Xu, Shuting Zang

Published in

Frontiers in neurology. Volume 17. Pages 1921237. Epub Sep 24, 2026.

Abstract

To explore the developmental trajectories of post-stroke fatigue and its influencing factors in young and middle-aged patients with intracerebral hemorrhage, and to provide theoretical basis for precise clinical nursing interventions.
A convenience sampling method was used to enroll 218 young and middle-aged patients with intracerebral hemorrhage who were admitted to the Emergency Intensive Care Unit (EICU) between July 2022 and July 2024. Assessments were conducted at four time points: within 24 h after neurological stabilization during the acute phase (T1), and at 1 month (T2), 6 months (T3), and 12 months (T4) post-discharge. The Fatigue Severity Scale (FSS), Connor-Davidson Resilience Scale (CD-RISC), Medical Outcomes Study Social Support Survey (MOS-SSS), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) were administered. Latent class growth modeling (LCGM) was used to identify the developmental trajectories of fatigue based on the 218 enrolled participants with Full Information Maximum Likelihood handling of missing data, and multinomial logistic regression was applied to analyze the influencing factors of trajectory group membership among the 180 participants who completed all four assessments.
(1) Three heterogeneous developmental trajectories of post-stroke fatigue were identified in young and middle-aged patients with intracerebral hemorrhage: low-level stable fatigue group (30.6%), moderate-level slowly resolving group (43.3%), and high-level persistent fatigue group (26.1%). (2) Multinomial logistic regression analysis showed that, using the low-level stable fatigue group as the reference, increasing age (OR = 1.085, p = 0.007; OR = 1.132, p = 0.001), having ≥2 chronic comorbidities (OR = 2.186, p = 0.014; OR = 3.418, p = 0.001), and higher NIHSS score (OR = 1.118, p = 0.004; OR = 1.194, p < 0.001) were common independent risk factors for entering both the moderate-level slowly resolving group and the high-level persistent fatigue group; psychological resilience (OR = 0.951, p = 0.003; OR = 0.924, p < 0.001) and social support (OR = 0.936, p = 0.004; OR = 0.908, p = 0.001) were common protective factors. Elevated fear of disease progression (OR = 1.112, p = 0.001) was an independent risk factor for entering the high-level persistent fatigue group, while having a college degree or above (OR = 0.395, p = 0.022) was an independent protective factor against entering the high-level persistent fatigue group.
There are three heterogeneous developmental trajectories of post-stroke fatigue in young and middle-aged patients with intracerebral hemorrhage. Although fatigue levels in most patients showed a resolving trend over time, approximately one-quarter of patients still exhibited persistent high-level fatigue. Healthcare providers should implement stratified and dynamic precision interventions based on different trajectory characteristics, with particular attention to patients who are older, have multiple comorbidities, severe neurological deficits, and high levels of fear of disease progression, while also considering patients' psychological resilience and social support during rehabilitation planning to promote effective fatigue relief.

PMID:
42851406
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

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