(Peer-Reviewed) The association between frailty of older stroke patients during hospitalization and one-year all-cause mortality: A multicenter survey in China
Xiao-Ming Zhang 张小明 ¹, Jing Jiao 焦静 ¹, Tao Xu 徐涛 ², Xin-Juan Wu 吴欣娟 ¹
¹ Department of Nursing, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital, China
中国 北京 北京协和医院 中国医学科学院 北京协和医学院护理部
² Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, China
中国 北京 中国医学科学院基础医学研究所 北京协和医学院基础学院 流行病与统计学系
Abstract
Objective
Frailty is a common geriatric syndrome defined as multiple deficits, impairing the capacity to figure out insult. Previous studies have reported a significant association between frailty and mortality in stroke patients. This study aimed to explore the association between frailty and mortality among older Chinese stroke patients.
Methods
This study was a secondary analysis of a multicenter prospective cohort study conducted in older Chinese inpatients from October 2018 to February 2020, and patients with a primary diagnosis of stroke including hemorrhage and ischemia, were included in our study. Frailty of older inpatients with stroke from six hospitals was measured by the FRAIL scale, and a one-year follow-up was performed by well-trained nurses of these hospitals via telephone. Multivariable logistic regression was used to detect the association between frailty and one-year mortality.
Results
A total of 530 stroke patients with an average age of 72.94 (SD = 5.79) years were included in the present study. There were 37 (7.0%) hemorrhagic strokes and 493 (93.0%) ischemic strokes, with 228 (43.0%) females in this population. The prevalence of frailty was 22.5%. In the logistic regression model with adjustment for age, sex, instrumental activities of daily living (IADL), basic activities of daily living (ADL), education, history of falls, BMI, smoking, alcohol consumption, low handgrip strength, type of stroke and polypharmacy, stroke patients with frailty had an increased risk of one-year mortality compared to those without frailty (OR = 3.38, 95% CI: 1.22–9.37, P = 0.019).
Conclusion
Our study indicated that frailty was an independent risk factor for one-year all-cause mortality among older stroke patients in China. Frailty may be an essential factor for clinicians to consider before making a comprehensive treatment, and corresponding mixed interventions, including exercise training and nutritional programs, need to be conducted among older stroke patients.
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