The effects of fatigue, pain, and depression on quality of life in ischemic stroke patients: The Bergen Stroke Study

Figures & data

Table 1 Characteristics of responders and nonresponders

	Responders n = 328	Nonresponders n = 213	P
Age	67.7	69.0	0.30
NIHSS score on admission, mean	4.3	6.0	<0.001
mRS, median	1	2	<0.001
Barthel Index score, mean	92	79	<0.001
	n (%)	n (%)
Female	122 (37)	96 (45)	0.07
Prior depression	47 (18)	30 (18)	0.80
Married	208 (66)	119 (58)	0.07
Employed	109 (36)	54 (28)	0.06
Prior stroke	64 (20)	48 (23)	0.45
Prior myocardial infarction	38 (12)	21 (10)	0.57
Diabetes mellitus	31 (10)	31 (15)	0.07
Hypertension	167 (52)	110 (52)	1.00
Smoking	76 (24)	60 (30)	0.18

Note: mRS scores were obtained on day seven or upon discharge, if discharged earlier.

Abbreviations: NIHSS, National Institute of Health Stroke Scale; mRS, modified Rankin Scale.

Table 2 Quality of life on follow-up in patients with cerebral infarction

Follow-up
EQ-5D*, median (IQR), n = 278	0.74 (0.62–0.88)
15D, median (IQR), n = 266	0.86 (0.74–0.93)
EQ-VAS, median (IQR), n = 278	7 (5–8)
Pain n (%), n = 328	157 (48%)
FSS, median (IQR), n = 307	4.8 (3–5.8)
Sleeping disturbances, n (%), n = 326	87 (27)
Depression HADS-D >= 8, n (%), n = 311	61 (20)
Barthel Index score, median (IQR), n = 288	100 (95–100)

Abbreviations: EQ-5D, EuroQol; IQR, interquartile range; EQ-VAS, EuroQol Visual Analogue Scale; FSS, Fatigue Severity Scale; HADS-D, Depression Subscale of the Hospital Anxiety and Depression Scale.

Table 3 Pair-wise correlation of different variables with EQ-VAS, EQ-5D total, and 15D in patients with cerebral infarction

Clinical variables	EQ-VAS n = 278		EQ-5D n = 279		15D n = 266
	Pair-wise correlation	P-value	Pair-wise correlation	P-value	Pair-wise correlation	P-value
Sex	−0.11	0.06	−0.14	0.009	−0.13	0.03
Age	−0.18	0.003	−0.15	0.006	−0.22	<0.001
During hospital stay
Prior depression	−0.37	<0.001	−0.34	<0.001	−0.41	<0.001
Prior stroke	−0.16	0.01	−0.10	0.10	−0.16	0.01
Prior myocardial infarction	0.01	0.83	0.01	0.80	−0.08	0.18
Diabetes mellitus	−0.05	0.45	−0.02	0.78	0.05	0.44
Smoking	−0.09	0.20	−0.12	0.04	−0.01	0.92
Hypertension	−0.09	0.15	−0.09	0.12	−0.01	0.89
Married	0.16	0.01	0.15	0.007	0.17	0.006
Employed	0.19	0.002	0.14	0.01	0.21	0.001
mRS day 7	−0.33	<0.001	−0.42	<0.001	−0.38	<0.001
Barthel Index score, day 7	0.34	<0.001	0.44	<0.001	0.43	<0.001
Follow-up
Pain VAS	−0.43	<0.001	−0.57	<0.001	−0.53	<0.001
HADS-D	−0.62	<0.001	−0.61	<0.001	−0.77	<0.001
FSS	−0.64	<0.001	−0.46	<0.001	−0.60	<0.001
Barthel Index score	0.53	<0.001	0.67	<0.001	0.67	<0.001
Sleep disturbances	−0.27	<0.001	−0.33	<0.001	−0.41	<0.001
EQ-VAS	–	–	0.67	<0.001	0.79	<0.001
EQ-5D	0.67	<0.001	–	–	0.76	<0.001
15D	0.79	<0.001	0.76	<0.001	–	–

Abbreviations: EQ-VAS, EuroQol Visual Analogue Scale; EQ-5D, EuroQol; mRS, modified Rankin Scale; VAS, visual analog scale; HADS-D, Depression Subscale of the Hospital Anxiety and Depression Scale; FSS, Fatigue Severity Scale.

Figure 1 Quality of life at follow-up in relation to none, one, two, or three of the symptoms (pain, fatigue, and depression) in patients with cerebral infarction.

Abbreviations: EQ-VAS, EuroQol Visual Analogue Scale; EQ-5D, EuroQol.

Table 4 Linear regression with EQ-VAS, EQ-5D, and 15D as dependent variables on follow-up in patients with cerebral infarction

	EQ-VAS		EQ-5D		15D
	Partial correlation	P-value	Partial correlation	P-value	Partial correlation	P-value
Sex	0.05	0.52	0.01	0.93	0.02	0.76
Age	−0.03	0.64	0.03	0.64	−0.15	0.04
Pain scale	−0.16	0.03	−0.48	<0.001	−0.31	<0.001
HADS-D	−0.18	0.01	−0.21	0.004	−0.50	<0.001
FSS	−0.44	<0.001	−0.12	0.10	−0.34	<0.001
Barthel Index score	0.37	<0.001	0.55	<0.001	0.52	<0.001
Sleep disturbances	−0.04	0.58	−0.01	0.87	−0.37	<0.001

Abbreviations: EQ-VAS, EuroQol Visual Analogue Scale; EQ-5D, EuroQol; HADS-D, Depression Subscale of the Hospital Anxiety and Depression Scale; FSS, Fatigue Severity Scale; 15D, a generic instrument of health-related quality of life.

Table 5 Linear regression with EQ-VAS, EQ-5D, and 15D as dependent variables and prognostic variables known during hospital stay

	EQ-VAS		EQ-5D		15D
	Partial correlation	P-value	Partial correlation	P-value	Partial correlation	P-value
Sex	−0.04	0.54	0.12	0.10	−0.09	0.23
Age	−0.15	0.03	−0.17	0.02	−0.22	0.002
Prior depression	−0.32	<0.001	−0.33	<0.001	−0.40	<0.001
Prior stroke	−0.12	0.08	−0.13	0.06	−0.15	0.04
Barthel score day 7	0.27	<0.001	0.45	<0.001	0.31	<0.001
Smoking	−0.19	0.006	−0.23	<0.001	−0.14	0.05

Abbreviations: EQ-VAS, EuroQol Visual Analog Scale; EQ-5D, EuroQol.

Table 6 Cox regression analysis including measure of quality of life

	Hazard ratio	95% confidence interval	P-value
EQ-5D	0.16	0.04–0.7	0.018
Age	1.08	1.03–1.12	0.001
Sex	0.55	0.23–1.3	0.18
Barthel Index	0.99	0.97–1.0	0.16

Abbreviation: EQ-5D, EuroQol.