Yang Xiaomin, Liu Zhuyun, Nie Dan, Li Shangzhi, Ye Richun, Wei Lin, Zhang Xiaopei
Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
Department of Nursing, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Top Stroke Rehabil. 2024 Dec 30:1-11. doi: 10.1080/10749357.2024.2448392.
To investigate the association between pre-stroke frailty and discharge destination in hospitalized older adults in China.
We conducted this prospective cohort study in a tertiary care hospital in China. We enrolled patients aged 60 years and older admitted to the hospital for acute stroke from January 2022 to May 2022. We used telephone tracking to record the destination of participants after discharge. Generalized estimating equations were used to determine the association between pre-stroke frailty and post-discharge destination.
Among the 230 participants enrolled, the prevalence of pre-stroke frailty was 75.2% and about 75.7% of participants chose to go home at discharge. 70.5% of pre-stroke frail patients chose to go home, compared with 91.2% for non-pre-stroke frail patients. The generalized estimating equation showed a statistical difference between the frailty and non-frailty groups in the post-discharge destination of acute stroke patients between different time points (Waldχ 36.428 and 13.893, P < 0.001 and 0.008, respectively). After adjustment for the group, the model showed an interaction effect of time and pre-stroke frail status on the post-discharge destination (P < 0.001). The results confirm the importance of pre-stroke frail status in predicting patients' post-discharge outcomes.
Pre-stroke frailty is related to the post-discharge destination and stroke prognosis in elderly Chinese. For Chinese families, most acute stroke patients choose to go home when they are discharged from the hospital, even those who are frail before acute stroke occurs. Further research is needed to confirm this finding and to actively intervene in the pre-stroke frail population.
探讨中国住院老年患者卒中前衰弱与出院目的地之间的关联。
我们在中国一家三级医院开展了这项前瞻性队列研究。纳入2022年1月至2022年5月因急性卒中入院的60岁及以上患者。我们通过电话追踪记录参与者出院后的去向。采用广义估计方程确定卒中前衰弱与出院后目的地之间的关联。
在纳入的230名参与者中，卒中前衰弱的患病率为75.2%，约75.7%的参与者出院时选择回家。卒中前衰弱患者中有70.5%选择回家，而非卒中前衰弱患者这一比例为91.2%。广义估计方程显示，不同时间点急性卒中患者出院后目的地在衰弱组与非衰弱组之间存在统计学差异（Waldχ分别为36.428和13.893，P均<0.001和0.008）。在对组进行调整后，模型显示时间与卒中前衰弱状态对出院后目的地存在交互作用（P<0.001）。结果证实了卒中前衰弱状态在预测患者出院后结局中的重要性。
卒中前衰弱与中国老年患者的出院目的地及卒中预后相关。对于中国家庭而言，大多数急性卒中患者出院时选择回家，即使是急性卒中发生前就衰弱的患者。需要进一步研究来证实这一发现，并对卒中前衰弱人群进行积极干预。
