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

Vasc Health Risk Manag. 2012;8:407-13. doi: 10.2147/VHRM.S32780. Epub 2012 Jun 27.


Background: Many patients with cerebral infarction suffer from symptoms such as pain, fatigue, and depression. The aim of this study was to evaluate these symptoms in relation to health-related quality of life (HRQoL) on long-term follow-up.

Materials and methods: All surviving stroke patients admitted to the Stroke Unit, Haukeland University Hospital, Norway between February 2006 and November 2008 were sent a questionnaire, including a visual analog pain scale, Fatigue Severity Scale, Depression Subscale of Hospital Anxiety and Depression Scale, Barthel Index, and three measures of HRQoL--15D, EuroQol, and EuroQol Visual Analogue Scale--at least 6 months after stroke onset. Cox regression survival analysis, including EQ-5D, was performed by November 2009.

Results: The questionnaire was returned by 328 patients. All three symptoms were reported by 10.1% of the patients, and 26% reported two symptoms. There was a significant association between worse HRQoL scores and an increasing number of cooccurring symptoms for all three HRQoL scores. Fatigue, depression, pain, functional state, and sleeping disorder on follow-up accounted for 58%-83% of the variability in HRQoL, depending on which HRQoL scale was used. Cox regression analysis showed that mortality was associated with a low EuroQol score (P = 0.016).

Conclusion: Pain, fatigue, and depression were common symptoms among these stroke patients and, to a large extent, they determined the patients' HRQoL. Low HRQoL was associated with increased mortality.

Keywords: cerebral infarction; mortality; symptoms.

MeSH terms

  • Aged
  • Brain Ischemia / diagnosis
  • Brain Ischemia / mortality
  • Brain Ischemia / psychology*
  • Chi-Square Distribution
  • Depression / diagnosis
  • Depression / mortality
  • Depression / psychology*
  • Fatigue / diagnosis
  • Fatigue / mortality
  • Fatigue / psychology*
  • Female
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Norway / epidemiology
  • Pain / diagnosis
  • Pain / mortality
  • Pain / psychology*
  • Pain Measurement
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Quality of Life*
  • Registries
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / mortality
  • Stroke / psychology*
  • Surveys and Questionnaires
  • Survival Analysis
  • Time Factors