Skip to main content
Log in

Predicting fatigue 1 year after aneurysmal subarachnoid hemorrhage

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Fatigue is an important contributor to quality of life in patients who survive aneurysmal subarachnoid hemorrhage (SAH), but the determinants of this fatigue are unclear. We assessed the occurrence of fatigue 1 year after SAH and its relation to physical or cognitive impairment, passive coping, and emotional problems, measured 3 months after SAH. This was a prospective cohort study of 108 patients who visited our SAH outpatient clinic 3 months after SAH and who were living independently in the community 1 year after SAH. Fatigue was evaluated using the Fatigue Severity Scale (FSS). Analysis of variance was used to analyze the data. Fatigue (FSS ≥4) was present in 77 patients (71%). Mean FSS scores were 4.1 (SD 1.6) in the group of patients having ‘neither physical nor cognitive impairment,’ 5.2 (1.4) having ‘either physical or cognitive impairment,’ and 5.9 (0.9) having ‘both physical and cognitive impairments.’ Mean FSS scores were higher in patients scoring high on passive coping (85 vs. 58%; RR 1.46, 95% CI 1.13–1.87), anxiety (84 vs. 55%; RR 1.53, 95% CI 1.17–2.02), or depression (85 vs. 62%; RR 1.36, 95% CI 1.08–1.72) than in patients without these complaints. Relationships between these complaints and FSS scores were higher in patients having neither physical nor cognitive impairments than in patients having physical or cognitive impairments. Fatigue is common after SAH and is related to physical and cognitive impairments. In patients with neither physical nor cognitive impairments, passive coping style and emotional problems are important predictors of fatigue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Al-Khindi T, MacDonald RL, Schweizer TA (2010) Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke 41:e519–e536

    Article  PubMed  Google Scholar 

  2. Passier PECA, Visser-Meily JMA, van Zandvoort MJE, Post MWM, Rinkel GJE, van Heugten C (2010) Prevalence and determinants of cognitive complaints after aneurysmal subarachnoid haemorrhage. Cerebrovasc Dis 29:557–563

    Article  CAS  PubMed  Google Scholar 

  3. Visser-Meily JMA, Rhebergen ML, Rinkel GJE, van Zandvoort MJ, Post MWM (2009) Long-term health related quality of life after aneurysmal subarachnoid hemorrhage; relationship with psychological symptoms and personality characteristics. Stroke 40:1526–1529

    Article  PubMed  Google Scholar 

  4. Ogden JA, Utley T, Mee EW (1997) Neurological and psychosocial outcome 4 to 7 years after subarachnoid hemorrhage. Neurosurgery 41:24–34

    Article  Google Scholar 

  5. Noble AJ, Baisch S, Mendelow AD, Allen L, Kane P, Schenk T (2008) Posttraumatic stress disorder explains reduced quality of life in subarachnoid hemorrhage patients in both the short and long term. Neurosurgery 63:1095–1105

    Article  PubMed  Google Scholar 

  6. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46:1121–1123

    CAS  PubMed  Google Scholar 

  7. van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJE (2008) Validation of a prognostic subarachnoid hemorrhage grading scale derived directly from the glasgow coma scale. Stroke 39:1347–1348

    Article  PubMed  Google Scholar 

  8. Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. Lancet 1:480–484

    Article  CAS  PubMed  Google Scholar 

  9. Eriksen HR, Olff M, Ursin H (1997) The CODE: a revised battery for coping and defense and its relation to subjective health. Scan J Psychol 38:175–182

    Article  CAS  Google Scholar 

  10. Spielberger CD, Gorsuch RL, Lushene PR, Vagg PR, Jacobs AG (1983) Manual for the state-trait anxiety inventory (form Y). Consulting Psychologists Press, Palo Alto

  11. Ploeg van der HM (2000) Handleiding bij de Zelf-beoordelings vragenlijst, een Nederlandse bewerking van de Spielberger Stait-Trait Anxiety Inventory, STAI-DY, Swets en Zeitlinger, Lisse

  12. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    CAS  PubMed  Google Scholar 

  13. Aben I, Verhey F, Lousberg R, Lodder J, Honig A (2003) Validity of beck depression inventory, hospital anxiety and depression scale, scl-90, and Hamilton depression rating scale as screening instruments for depression in stroke patients. Psychosomatics 43:386–393

    Article  Google Scholar 

  14. Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New York

    Google Scholar 

  15. Nys GMS, van Zandvoort MJE, van der Worp HB et al (2006) Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke. J Neurol Sci 247:149–156

    Article  CAS  PubMed  Google Scholar 

  16. Verhage F (1964) Intelligentie en leeftijd: Onderzoek bij Nederlanders van twaalf tot zevenenzeventig jaar (Intelligence and age: study with Dutch people from age 12 to 77). Van Gorcum, Assen

    Google Scholar 

  17. Hellawell DJ, Taylor R, Pentland B (1999) Persisting symptoms and carers’ views of outcome after subarachnoid haemorrhage. Clin Rehabil 13:333–340

    Article  CAS  PubMed  Google Scholar 

  18. Schuiling WJ, Rinkel GJE, Walchenbach R, de Weerd AW (2005) Disorders of sleep and wake in patients after subarachnoid hemorrhage. Stroke 36:578–582

    Article  PubMed  Google Scholar 

  19. Kreitschmann-Andermahr I, Poll E, Hütter BO, Reineke A, Kristes S, Gilsbach JM (2007) Quality of life and psychiatric sequelae following aneurysmal subarachnoid haemorrhage: does neuroendocrine dysfunction play a role? Clin Endocrin 66:833–837

    Article  Google Scholar 

  20. Klose M, Brennum J, Poulsgaard L, Kosteljanetz M, Wagner A, Feldt-Rasmussen U (2010) Hypopituitarism is uncommon after aneurysmal subarachnoid haemorrhage. Clin Endocrinol 73:95–101

    Google Scholar 

Download references

Conflict of interest

None declared.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. E. C. A. Passier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Passier, P.E.C.A., Post, M.W.M., van Zandvoort, M.J.E. et al. Predicting fatigue 1 year after aneurysmal subarachnoid hemorrhage. J Neurol 258, 1091–1097 (2011). https://doi.org/10.1007/s00415-010-5891-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-010-5891-y

Keywords

Navigation