Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Age Ageing. 2022 Apr 1;51(4). doi: 10.1093/ageing/afac096.
frailty has been shown to be a better predictor of clinical outcomes than age alone across many diseases. Few studies have examined the relationship between frailty, stroke and stroke interventions such as endovascular thrombectomy (EVT).
we aimed to investigate the impact of frailty measured by clinical frailty scale (CFS) on clinical outcomes after EVT for acute ischemic stroke (AIS) in older patients ≥70 years.
in this retrospective cohort study, we included all consecutive AIS patients age ≥ 70 years receiving EVT at a single comprehensive stroke centre. Patients with CFS of 1-3 were defined as not frail, and CFS > 3 was defined as frail. The primary outcome was modified Rankin Score (mRS) at 90 days. The secondary outcomes included duration of hospitalisation, in-hospital mortality, carer requirement, successful reperfusion, symptomatic intracranial haemorrhage and haemorrhagic transformation.
a total of 198 patients were included. The mean age was 78.1 years and 52.0% were female. Frail patients were older, more likely to be female, had more co-morbidities. CFS was significantly associated with poor functional outcome after adjustment for age, NIHSS and time to intervention (adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.04-2.28, P = 0.032). There was trend towards higher mortality rate in frail patients (frail: 18.3%; non-frail: 9.6%; P = 0.080). There were no significant differences in other secondary outcomes except increased carer requirement post discharge in frail patients (frail: 91.6%; non-frail: 72.8%; P = 0.002).
frailty was associated with poorer functional outcome at 90 days post-EVT in patients ≥ 70 years.
在许多疾病中，衰弱程度比年龄更能预测临床结局。很少有研究探讨衰弱与中风以及中风干预措施（如血管内血栓切除术 [EVT]）之间的关系。
我们旨在研究通过临床衰弱量表（CFS）测量的衰弱程度对 70 岁以上接受急性缺血性中风（AIS）EVT 的老年患者的临床结局的影响。
在这项回顾性队列研究中，我们纳入了在单一综合中风中心接受 EVT 的所有连续的 AIS 患者，年龄≥70 岁。CFS 评分为 1-3 的患者被定义为非衰弱，CFS 评分>3 被定义为衰弱。主要结局为 90 天改良 Rankin 量表（mRS）评分。次要结局包括住院时间、住院期间死亡率、护理人员需求、再灌注成功、症状性颅内出血和出血性转化。
共纳入 198 例患者。平均年龄为 78.1 岁，52.0%为女性。衰弱患者年龄更大，更可能为女性，合并症更多。在调整年龄、NIHSS 和干预时间后，CFS 与功能预后不良显著相关（调整后优势比 [aOR] 1.54，95%置信区间 [CI] 1.04-2.28，P=0.032）。衰弱患者的死亡率有升高趋势（衰弱：18.3%；非衰弱：9.6%；P=0.080）。除出院后护理人员需求增加外（衰弱：91.6%；非衰弱：72.8%；P=0.002），其他次要结局无显著差异。
70 岁以上患者 EVT 后 90 天，衰弱与功能结局较差相关。
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