Pre-Stroke Frailty Measured by The Clinical Frailty Scale Can Predict Post-Stroke Disability
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Authors
Reehal, Kiran K.
Date
2024-01-09
Type
thesis
Language
eng
Keyword
Frailty , modified Rankin Scale , Clinical Frailty Scale , Stroke
Alternative Title
Abstract
Background and Aims: The aim of this study was to determine the association of pre-stroke frailty, measured using the Clinical Frailty Scale (CFS) with post-stroke disability, measured using the modified Rankin Scale (mRS) at 3 months.
Methods: This single centre prospective cohort study included imaging confirmed ischemic stroke patients admitted to Kingston Health Sciences Centre between January 2022 and February 2023. Frailty was categorized as non-frail (CFS: 0-4) or frail (CFS: 5-9), and post-stroke disability was a mRS score of 3-6. The statistical analysis was done using SPSS. Descriptive statistics followed by binary logistic regression were performed to assess the association between pre-stroke frailty and post-stroke disability. The covariates for testing this association were selected based on a priori knowledge and the literature.
Results: 459 stroke patients were included in the study with a median (IQR) age of 76 (65-84) years and 230 (50.1%) patients were male. The prevalence of pre-stroke frailty (based on the CFS) and post-stroke disability (based on mRS) was 199 (43.4%) and 245 (53.4%), respectively. Pre-stroke frailty was strongly associated with post-stroke disability with a crude odds ratio (OR) of 10.35 (95% CI:6.61-16.23) and OR adjusted for age, sex, COPD, dementia, heart disease, stroke, and cancer was 6.52 (95% CI:3.98-10.69).
Conclusions: Pre-stroke frailty measured using the CFS is an important predictor of stroke disability at 3 months and should be incorporated in the clinical decision-making pathway. Further exploration of pre-stroke frailty and its interaction with various hyperacute stroke treatments is warranted.