Objective To analyze the trajectory categories of fatigue development in middle-aged and elderly stroke patients and explore its influencing factors.

Methods A convenient sampling method was used to select 230 middle-aged and elderly stroke patients in the Luzhou People's Hospital from January 2021 to January 2023 as the research subjects. A self-compiled general information-questionnaire, the Fatigue Severity Scale (FSS), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI) were used to investigate the sociodemographic and clinical data, fatigue, sleep quality, and depression status of patients at 2 days after admission and 3 and 6 months after discharge. The latent growth curve model was used to fit the categories and trajectories of fatigue development, and the unordered multinomial Logistic regression model was used to analyze the influencing factors of trajectory categories of fatigue development.

Results The fatigue development trajectory of middle-aged and elderly stroke patients showed three potential categories, namely the low-level fatigue stability group (33.04%), the medium-level fatigue rapid aggravation group (42.17%), and the high-level fatigue slow aggravation group (24.79%). The results of unordered multinomial Logistic regression analysis showed that age, marital status, education level, disease severity, the Activity of Daily Living (ADL) score, PSQI score, and BDI score were the influencing factors of fatigue development trajectory in middle-aged and elderly stroke patients (all P < 0.05).

Conclusion The fatigue development trajectory of middle-aged and elderly stroke patients is heterogeneous. Nurses should understand the evolution characteristics of fatigue in different patients and implement targeted management measures according to patients'symptoms to improve their health outcomes.