Post-Stroke Fatigue in Patients at 3 Months After Ischemic Stroke: Analysis From the FRAILTY Study.

Introduction: Post-stroke fatigue (PSF) is a known sequel after ischemic stroke (IS), which affects quality of life (QoL), however its incidence and contributing factors remain controversial or not enough established, especially in younger population in working age. Objectives: To assess PSF in patients in working age (18-65 years) at 3 months after IS and evaluate its possible association to other factors. Methods: Consecutive patients with IS in working age enrolled in the prospective FRAILTY (Factors Affecting the Quality of Life After Ischemic Stroke in Young Adults; ClinicalTrials.gov: NCT04839887) were analyzed. PSF was assessed using Fatigue Severity Scale (FSS) and Neuro_QoL_Fatigue scale, post-stroke depression (PSD) and anxiety (PSA) using Hospital Anxiety and Depression Scale at 3 months after IS. QoL was evaluate using Stroke Impact Scale (SIS), version 3.0. Logistic regression analysis (LRA) was performed to identify possible predictors of PSF. Results: In total, 150 (54.0% males, mean age 51.2 ± 8.9 years) were analyzed and 132 (88%) had excellent clinical outcome after 3 months. PSF, based on the FSS, was present in 55.3% of patients and severe PSF in 41.3% of them. LRA showed the significant association between SIS domains memory, emotions, communication, mobility and participation and the presence of severe PSF (FSS score > 5). PSD and PSA were found as other predictors of severe PSF. No association was found between PSF and age, sex, and clinical outcome. Conclusions: Despite overall excellent clinical outcome, severe PSF occurred in 41.3% of patients in working age after 3 months post-stroke. PSF affected strongly QoL and may have close relationship to psychosocial factors and cognition. Routine screening for PSF should be incorporated into post-stroke follow up, especially for working-age patients.