Fatigue in relation to long-term participation outcome in aneurysmal subarachnoid hemorrhage survivors.

OBJECTIVE To examine the association of fatigue with long-term participation in aneurysmal sub-arachnoid haemorrhage survivors. DESIGN Cohort study, 4 years post-onset. SUBJECTS A total of 59 patients with aneurysmal subarachnoid haemorrhage. METHODS Participation performance was assessed with the Sickness Impact Profile-68, participation autonomy and problem experience with the Impact on Participation and Autonomy questionnaire, and community integration with the Community Integration Questionnaire. Fatigue was assessed with the Fatigue Severity Scale and depression with the Center for Epidemiologic Studies-Depression scale. Multivariable linear regression analyses were performed. RESULTS Fifty-nine survivors (mean age 53.0 years, standard deviation (SD) 10.8 years) were inclu-ded, of which 59.3% was fatigued. Fatigued patients had significantly worse participation scores than non-fatigued patients regarding performance (p < 0.001), autonomy indoors (p = 0.001), auto-nomy outdoors (p = 0.002) and problem experience (p = 0.001), but not regarding community integ-ration. More severe fatigue was related to worse participation in terms of performance (B = 2.79, p < 0.001) and problem experience (B = 0.08, p = 0.003), adjusted for depression and inpatient reha-bilitation. CONCLUSION Four years after onset, many survivors of aneurysmal subarachnoid haemorrhage have persistent fatigue, which is independently associated with reduced participation in activities of daily living. Therefore, future studies should investigate whether rehabilitation programs that focus on fatigue are effective in improving long-term participation outcomes after aneurysmal subarachnoid haemorrhage.