Impact of Pre-Stroke Frailty on Outcome Three Years after Acute Stroke: The Nor-COAST Study.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY Cerebrovascular Diseases Pub Date : 2024-09-25 DOI:10.1159/000541565

Ragnhild Munthe-Kaas, Stian Lydersen, Terry Quinn, Stina Aam, Sarah T Pendlebury, Hege Ihle-Hansen

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Abstract

Introduction: We aimed to explore the predictive value of pre-stroke frailty index (FI) on functional dependency and mortality 3 years after stroke.

Methods: Based on the Rockwood 36-item FI score, we calculated the pre-stroke FI from medical conditions recorded at baseline in the multicenter prospective Nor-COAST study 2015-2017. Participants with a FI score and a modified Rankin scale (mRS) 0-6 3 years post-stroke were included in this study. We used logistic regression analysis with unfavorable mRS (over 2 vs. 0-2) at 3 years, or dead within 3 years, as dependent variable, and frailty and pre-stroke mRS, one at a time, and simultaneously, as predictors. The analyses were carried out unadjusted and adjusted for the following variables one at a time: Age, sex, years of education, stroke severity at admission, infections treated with antibiotics and stroke progression. We report odds ratio (OR) per 0.10 increase in FI.

Results: At baseline, the 609 included patients had mean age 72.8 (standard deviation [SD] 11.8), 261 (43%) were females, and had a FI mean score of 0.16 (SD 0.12), range 0-0.69. During 3 years, 138 (23%) had died. Both the FI, and pre-stroke mRS, were strong predictors for unfavorable mRS (OR 4.1 and 2.7) and dead within 3 years (OR 2.2 and 1.7). Only adjusting for age affected the result. The OR for pre-stroke mRS decreased relatively more than the OR for FI when entered as predictors simultaneously.

Conclusions: FI is a stronger predictor than premorbid mRS for prognostication after stroke.

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中风前体弱对急性中风三年后预后的影响：北部海岸研究。

背景我们旨在探讨卒中前虚弱指数（FI）对卒中三年后功能依赖性和死亡率的预测价值：基于 Rockwood 36 项 FI 评分，我们根据 2015-2017 年多中心前瞻性 Nor-COAST 研究中基线记录的医疗状况计算出了卒中前 FI。本研究纳入了具有 FI 评分和卒中后三年改良兰金量表（mRS）0-6 分的参与者。我们采用逻辑回归分析法，将卒中后 3 年的不利 mRS（2 分以上与 0-2 分）或 3 年内死亡作为因变量，将虚弱程度和卒中前 mRS 作为预测因素，一次一个，同时进行。分析未经调整，并对以下变量逐一进行了调整：年龄、性别、受教育年限、入院时脑卒中严重程度、接受抗生素治疗的感染和脑卒中进展。我们报告了 FI 每增加 0.10 的比值比 (OR)：基线时，609 名纳入患者的平均年龄为 72.8 岁（标清 11.8），261 名（43%）为女性，FI 平均分为 0.16 分（标清 0.12 分），范围为 0 至 0.69 分。三年中，138 人（23%）死亡。FI和卒中前的mRS都是不良mRS（OR 4.1和2.7）和3年内死亡（OR 2.2和1.7）的有力预测因素。只有调整年龄才会影响结果。同时作为预测因子时，卒中前 mRS 的 OR 比 FI 的 OR 降低得更多：结论：FI 是比卒中前 mRS 更强的卒中预后预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cerebrovascular Diseases 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.