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February 26, 2026BMC Neurology0 citationsOpen Access

Incidence and related risk factors of post-stroke fatigue in patients with hemorrhagic stroke: a systematic review and meta-analysis

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ZHZhiyu HeLZLi ZhongYCY. X. Chen

Key Points

  • To evaluate the incidence and related risk factors of post-stroke fatigue in patients with hemorrhagic stroke.
  • Conducted a systematic review and meta-analysis
  • Searched multiple databases for relevant studies
  • Included 16 studies involving 1,997 patients with hemorrhagic stroke
  • Analyzed data using Stata 18.0 and RevMan 5.4
  • Assessed quality and extracted data independently by two reviewers
  • Identified a 51% incidence of post-stroke fatigue
  • Weak correlations found with marital status, sleep disturbance, and postoperative complications
  • Moderate correlations identified for modified Rankin Scale score, Hunt–Hess grade, anxiety, and social support
  • Strong correlation with depression
  • Subgroup analyses showed regional and clinical differences in PSF incidence

Abstract

Post-stroke fatigue (PSF) is a long-lasting sequela in patients with hemorrhagic stroke, substantially hindering neurological recovery and social integration. The complex and multifactorial nature of PSF complicates its clinical management, highlighting the need for systematic studies to elucidate its risk factors and facilitate the development of targeted interventions. To evaluate the incidence and developmental trends of PSF and analyze the related risk factors, we conducted a meta-analysis. The databases Web of Science, MEDLINE, PubMed, CINAHL, Embase, Scopus, Cochrane Library, PsycINFO, CNKI, VIP, Wanfang, and SinoMed were systematically searched for publications from inception to February 2025. Two reviewers independently screened the literature, assessed quality, and extracted data. The PSF incidence was performed using Stata 18.0, risk factor analysis was determined using RevMan 5.4. Sixteen studies involving 1,997 patients with hemorrhagic stroke were included ultimately. The incidence of PSF was 51%. Subgroup analyses revealed regional and clinical differences between groups. Marital status(r = 0.24, p < 0.001), sleep disturbance(r = 0.29, p < 0.001), and postoperative complications(r = 0.26, p < 0.001) were weakly correlated with PSF. Moderate correlations were identified for the modified Rankin Scale score(r = 0.37, p < 0.001), Hunt–Hess grade(r = 0.36, p < 0.001), anxiety(r = 0.35, p = 0.001), and social support(r = 0.31, p < 0.001), whereas depression(r = 0.63, p = 0.008) emerged with a strong correlation. Nearly half of patients with hemorrhagic stroke were susceptible to PSF. Variations in the reported PSF incidence across studies may be attributed to the area of onset, study type, disease type, and time of assessment. The early identification of PSF in patients with hemorrhagic stroke is essential for implementing timely and effective interventions.

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Cite This Study

He et al. (2026) studied this question.

synapsesocial.com/papers/699f95951bc9fecf3dab3822https://doi.org/10.1186/s12883-026-04724-9
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