Frailty is an outcome predictor in patients with acute ischemic stroke receiving endovascular treatment

Age and Ageing - Tập 50 Số 5 - Trang 1785-1791 - 2021
João Pinho1, Charlotte Küppers1, Omid Nikoubashman2, Martin Wiesmann2, Jörg B. Schulz1,3, Arno Reich1, Cornelius J. Werner4
1Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
2Department of Neuroradiology, Medical Faculty, RWTH Aachen University, Aachen D-52074, Germany
3JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen D-52074, Germany
4Department of Neurology, Medical Faculty, Section Interdisciplinary Geriatrics, RWTH Aachen University, Aachen D-52074, Germany

Tóm tắt

Abstract Introduction Frailty is a disorder of multiple physiological systems impairing the capacity of the organism to cope with insult or stress. It is associated with poor outcomes after acute illness. Our aim was to study the impact of frailty on the functional outcome of patients with acute ischemic stroke (AIS) submitted to endovascular stroke treatment (EST). Methods We performed a retrospective study of patients with AIS of the anterior circulation submitted to EST between 2012 and 2017, based on a prospectively collected local registry of consecutive patients. The Hospital Frailty Risk Score (HFRS) at discharge was calculated for each patient. We compared groups of patients with and without favourable 3-month outcome after index AIS (modified Rankin Scale 0–2 and 3–6, respectively). A multivariable logistic regression model was used to identify variables independently associated with favourable 3-month outcome. Diagnostic test statistics were used to compare HFRS with other prognostic scores for AIS. Results We included 489 patients with median age 75.6 years (interquartile range [IQR] = 65.3–82.3) and median NIHSS 15 (IQR = 11–19). About 29.7% presented a high frailty risk (HFRS >15 points). Patients with favourable 3-month outcome presented lower HFRS and lower prevalence of high frailty risk. High frailty risk was independently associated with decreased likelihood of favourable 3-month outcome (adjusted odds ratio = 0.48, 95% confidence interval = 0.26–0.89). Diagnostic performances of HFRS and other prognostic scores (THRIVE and PRE scores, SPAN-100 index) for outcome at 3-months were similar. Discussion Frailty is an independent predictor of outcome in AIS patients submitted to EST.

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Age and Ageing

Tập 50 Số 5

1785-1791

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