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首页> 外文期刊>Cerebrovascular diseases >The triad of pain, fatigue and depression in ischemic stroke patients: The bergen stroke study
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The triad of pain, fatigue and depression in ischemic stroke patients: The bergen stroke study

机译：缺血性中风患者的疼痛，疲劳和抑郁三联征：卑尔根中风研究

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Background: Many patients with cerebral infarction suffer from symptoms such as pain, fatigue and depression. Most studies focus on single symptoms, but these symptoms often occur together. Whereas symptom clusters have been studied in cancer patients, little is known about different symptom clusters in patients with cerebral infarction. The aim was to evaluate clusters of co-occurring symptoms in the long term. We hypothesized that patients with cerebral infarction display distinct symptom clusters. Furthermore, we hypothesized that multiple co-occurring symptoms have an adverse effect on patients. Methods: All consecutive patients with acute stroke (the index stroke) admitted to the Stroke Unit, Department of Neurology, Haukeland University Hospital, between February 2006 and July 2008, were prospectively registered in a database. Prior risk factors (including diabetes mellitus, hypertension, smoking, coronary heart disease, atrial fibrillation and prior stroke), prior depression and stroke severity (modified Rankin Scale (mRS) score on day 7) were registered. Patients with cerebral infarction were sent a questionnaire including a visual analogue pain scale (VAS), Fatigue Severity Scale (FSS), depression subscale of the Hospital Anxiety, Depression Scale (HADS-D) and Barthel Index at least 6 months after stroke onset. Results: The questionnaire was returned by 328 patients (response rate 60%). All three symptoms were reported by 10.1%. Pain and fatigue among nondepressed patients were reported by 19.6%. Pain and depression among nonfatigued patients were reported by 2.0%. Depression and fatigue, and no pain were reported by 4.4%. Single symptoms were reported by 31% whereas 33% reported no symptoms. VAS, FSS and HADS-D score severity increased with the number of co-occurring symptoms. Logistic regression analyses showed that two or three symptoms (versus no symptoms) was associated with high mRS score on day 7 (p = 0.02), prior stroke (p = 0.002), prior diabetes mellitus (p = 0.005) and prior depression (p < 0.001). Conclusions: Symptom clusters are frequent in patients with cerebral infarction. Fatigue was associated with pain and depression whereas there was little association between depression and pain in nonfatigue patients, indicating distinct symptom clusters. The severity of symptoms increased with the number of co-occurring symptoms.
机译：背景：许多脑梗塞患者患有疼痛，疲劳和抑郁等症状。大多数研究集中于单一症状，但这些症状通常同时发生。尽管已经在癌症患者中研究了症状群，但对脑梗死患者中不同症状群的了解却很少。目的是长期评估同时发生的症状。我们假设脑梗死患者表现出明显的症状群。此外，我们假设多种同时出现的症状会对患者产生不利影响。方法：前瞻性于2006年2月至2008年7月之间进入豪克兰大学医院神经科的卒中科连续收治的所有急性卒中（索引性卒中）患者。记录先前的危险因素（包括糖尿病，高血压，吸烟，冠心病，心房纤颤和先前的中风），先前的抑郁和中风严重程度（第7天的改良兰金量表（mRS）评分）。脑梗死患者至少在卒中发生后6个月接受问卷调查，包括视觉模拟疼痛量表（VAS），疲劳严重程度量表（FSS），医院焦虑抑郁量表，抑郁量表（HADS-D）和Barthel指数。结果：328例患者返回了问卷（回应率为60％）。三种症状均报告为10.1％。非抑郁患者的疼痛和疲劳报告为19.6％。据报道，未疲劳患者的疼痛和抑郁感为2.0％。 4.4％的人报告有抑郁和疲劳，并且没有疼痛。报告为单一症状的有31％，而没有报告为33％。 VAS，FSS和HADS-D评分的严重程度随同时出现的症状数而增加。 Logistic回归分析显示，第7天（p = 0.02），先前中风（p = 0.002），先前糖尿病（p = 0.005）和先前抑郁（p = 0.02）时，有两种或三种症状（相对于无症状）与高mRS评分相关。 <0.001）。结论：脑梗死患者经常出现症状群。疲劳与疼痛和抑郁相关，而非疲劳患者的抑郁和疼痛之间几乎没有关联，表明明显的症状群。症状的严重程度随同时出现的症状数而增加。

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