Abstract Background and aims Assessment of frailty in patients with acute stroke is limited by several factors. Little is known about the feasibility of frailty assessment early after hospital admission and about specific limitations of available instruments in this setting. Methods In this retrospective study, consecutive patients ≥70 years with acute ischemic stroke (AIS), transient ischemic attack (TIA) or intracerebral hemorrhage admitted to a stroke unit underwent early systematic assessment of frailty using several instruments. Feasibility, correlation between the several instruments and association with outcomes was analysed. Results A total of 379 patients were included in the study, median age was 81 years, 55% were female. Median time from admission to assessment was 1 day (IQR 1-2). Most of the frailty assessment instruments had a high feasibility (95%), except for hand grip strength and skeletal muscle index. The highest correlation between instruments was found for pre-stroke Clinical Frailty Scale (CFS) and pre-stroke Identification of Seniors At Risk (ISAR) (rho 0.619, p0.001). Only pre-stroke CFS and pre-stroke ISAR were independent predictors of both functional dependency at discharge (odds ratio OR per 1-point increase=2.08, 95%CI=1.68-2.58, and OR per 1-point increase=2.56, 95%CI=1.75-2.90, respectively) and of in-hospital mortality (OR per 1-point increase=1.72, 95%CI=1.31-2.26, and OR per 1-point increase=1.49, 95%CI=1.05-2.12, respectively). Conclusions Assessment of pre-stroke frailty early after stroke unit admission because of AIS, TIA or intracerebral hemorrhage is feasible in the majority of patients. In this setting, global measures of frailty such as the CFS and ISAR appear to be the most adequate. Conflict of interest All authors: nothing to desclose.
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Marcus Rust
Simone Tauber
Cornelius J. Werner
European Stroke Journal
RWTH Aachen University
Bielefeld University
Universitätsklinikum Aachen
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Rust et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7ef7bfa21ec5bbf0742e — DOI: https://doi.org/10.1093/esj/aakag023.430