Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Anesthesia and Perioperative and Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Clin Rehabil. 2024 Dec;38(12):1691-1702. doi: 10.1177/02692155241290258. Epub 2024 Oct 14.
To investigate the association between prestroke frailty and nonhome discharge, prolonged length of stay as well as functional outcomes.
Prospective observational study.
Single urban teaching hospital in Guangzhou, China.
Consecutive sample of 271 older patients admitted with acute stroke.
N/A.
A five-item FRAIL scale (0∼5 points) and the stroke severity at onset were measured. The primary outcome of interest was nonhome discharge, with secondary outcomes including prolonged length of stay and worse short-term prognosis. Multivariable logistic regression adjusting for confounding factors was used to determine the association between patient-reported frailty and nonhome discharge, prolonged length of stay, worse short-term prognosis.
The population had a median age of 68 [interquartile range (IQR), 64∼74)]years, with 50 individuals (18.5%) identified as frail. After adjusting for age, sex, Barthel index, National Institutes of Health Stroke Scale, and Mini-Mental Status Exam score at admission, patients with self-reported frailty were significantly likely to experience nonhome discharge (Odds Ratio [] = 4.788; 95% confidence interval [CI] = 1.272∼18.017; = .021), prolonged length of stay ( = 4.76; 95% CI= 1.80∼12.56; = .002), mRS scores at 30 days ( = 6.72;95% CI= 1.79∼25.20; = .005) and three months postdischarge and three-month ( = 8.94; 95% CI= 2.10∼38.08; = .003).
In older adults with stroke, frailty is associated with nonhome discharge, prolonged length of stay, and worse short-term prognosis, regardless of the stroke severity, cognition, and Barthel index score at admission. FRAIL scale can be used as a practical screening tool in acute care setting by multidisciplinary team in supporting discharge process.
探讨卒中前虚弱与非居家出院、住院时间延长以及功能结局的关系。
前瞻性观察性研究。
中国广州的一家城市教学医院。
连续纳入 271 名因急性卒中入院的老年患者。
无。
采用 5 项 FRAIL 量表（0∼5 分）和卒中发病时的严重程度进行评估。主要结局指标是非居家出院，次要结局指标包括住院时间延长和短期预后较差。多变量逻辑回归调整混杂因素后，确定患者报告的虚弱与非居家出院、住院时间延长、短期预后较差之间的关系。
该人群的中位年龄为 68 岁[四分位数间距（IQR），64∼74]岁，50 人（18.5%）被确定为虚弱。在校正年龄、性别、巴氏量表、国立卫生研究院卒中量表和入院时的简易精神状态检查评分后，自我报告虚弱的患者非居家出院的可能性显著增加（优势比 [OR] [95%置信区间（CI）] = 4.788；1.272∼18.017；= 0.021）、住院时间延长（= 4.76；95% CI = 1.80∼12.56；= 0.002）、30 天改良 Rankin 量表（mRS）评分（= 6.72；95% CI = 1.79∼25.20；= 0.005）和 3 个月出院时 mRS 评分（= 8.94；95% CI = 2.10∼38.08；= 0.003）。
在老年卒中患者中，虚弱与非居家出院、住院时间延长和短期预后较差相关，与卒中严重程度、认知和入院时巴氏量表评分无关。FRAIL 量表可作为多学科团队在急性护理环境中使用的实用筛查工具，以支持出院过程。
