The impact of frailty on short-term prognosis in discharged adult stroke patients: A multicenter prospective cohort study.
Int J Nurs Stud
; 154: 104735, 2024 Jun.
Article
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| MEDLINE
| ID: mdl-38521005
ABSTRACT
BACKGROUND:
Frailty is commonly observed in stroke patients and it is associated with adverse outcomes. However, there remains a gap in longitudinal studies investigating the causal relationship between baseline frailty and short-term prognosis in discharged adult stroke patients.OBJECTIVE:
To examine the causal impact of frailty on non-elective readmission and major adverse cardiac and cerebral events, and investigate its associations with cognitive impairment and post-stroke disability.DESIGN:
A multicenter prospective cohort study.SETTING:
Two tertiary hospitals in Central and Northwest China.PARTICIPANTS:
667 adult stroke patients in stroke units were included from January 2022 to June 2022.METHODS:
Baseline frailty was assessed by the Frailty Scale. Custom-designed questions were utilized to assess non-elective readmission and major adverse cardiac and cerebral events as primary outcomes. Cognitive impairment, assessed using the Mini-Mental State Examination Scale (MMSE), and post-stroke disability, measured with the Modified Rankin Scale (mRS), were considered secondary outcomes at a 3-month follow-up. The impact of baseline frailty on non-elective readmission and major adverse cardiac and cerebral events was examined using bivariate and multiple Cox regression analyses. Furthermore, associations between baseline frailty and cognitive impairment, or post-stroke disability, were investigated through generalized linear models.RESULTS:
A total of 5 participants died, 12 had major adverse cardiac and cerebral events, and 57 had non-selective readmission among 667 adult stroke patients. Frailty was an independent risk factor for non-selective readmission (hazard ratio [HR] 2.71, 95â¯% confidence interval [CI] 1.59, 4.62) and major adverse cardiac and cerebral events (HR 3.77, 95â¯% CI 1.07, 13.22) for stroke patients. Baseline frailty was correlated with cognitive impairment (regression coefficient [ß] -2.68, 95â¯% CI -3.78, -1.58) adjusting for socio-demographic and clinical factors and follow-up interval. However, the relationship between frailty and cognitive impairment did not reach statistical significance when further adjusting for baseline MMSE (ß -0.39, 95â¯% CI -1.43, 0.64). Moreover, baseline frailty was associated with post-stroke disability (ß 0.36, 95â¯% CI 0.08, 0.65) adjusting for socio-demographic and clinical variables, follow-up interval, and baseline mRS.CONCLUSIONS:
The finding highlights the importance of assessing baseline frailty in discharged adult stroke patients, as it is significantly associated with non-elective readmission, major adverse cardiac and cerebral events, and post-stroke disability at 3â¯months. These results highlight the crucial role of screening and evaluating frailty status in improving short-term prognosis for adult stroke patients. Interventions should be developed to address baseline frailty and mitigate the short-term prognosis of stroke. TWEETABLE ABSTRACT Baseline frailty predicts non-elective readmission, major adverse cardiac and cerebral events, and post-stroke disability in adult stroke patients. @haiyanhexyyy.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Alta del Paciente
/
Accidente Cerebrovascular
/
Fragilidad
País/Región como asunto:
Asia
Idioma:
En
Revista:
Int J Nurs Stud
Año:
2024
Tipo del documento:
Article