학술논문
The added value of frailty assessment as the premorbid stroke status on activities of daily living in patients with acute stroke, stratified by stroke severity.
Document Type
Academic Journal
Author
Nozoe M; Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan. Electronic address: masafumi.nozoe@gmail.com.; Inoue T; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan.; Ogino T; Department of Physical Therapy,Faculty of Rehabilitation, Hyogo Medical University, Kobe, Japan.; Okuda K; Department of Rehabilitation, Konan Medical Center, Kobe, Japan.; Yamamoto K; Department of Rehabilitation, Konan Medical Center, Kobe, Japan.
Source
Publisher: Elsevier Masson SAS on behalf of SERDI Publisher Country of Publication: France NLM ID: 100893366 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1760-4788 (Electronic) Linking ISSN: 12797707 NLM ISO Abbreviation: J Nutr Health Aging Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The modified Rankin scale (mRS) is extensively used for premorbid evaluation in patients with stroke; however, its limited capacity to assess functional status highlights the need for additional indicators such as frailty.
Aims: This study aimed to assess the impact of the premorbid mRS score and frailty on daily living (ADL) activities at hospital discharge, focusing on varying stroke severities.
Methods: This single-centre, prospective cohort study included patients with acute stroke aged ≥60 years. Key metrics included the frailty index for frailty assessment or mRS for functional status premorbid and the functional independence measure of the motor domain (FIM-M) at discharge for ADL outcomes. The patients were categorized into mild (0-4), moderate (5-15), and severe (16-42) groups based on the National Institute of Health Stroke Scale. Multiple hierarchical linear regression analyses were performed for each group to evaluate the influence of mRS and frailty on FIM-M scores.
Results: In the mild stroke group, significant associations were observed with premorbid mRS3 (β = -0.183, p = 0.004), mRS4 (β = -0.234, p < 0.001), and frailty status (β = -0.227, p = 0.005) and FIM-M scores. Premorbid frailty did not show a significant association with the FIM-M scores in the moderate or severe stroke group. Frailty status notably contributed to changes in R², particularly in the mild stroke group (R² change = 0.031, p = 0.002). However, such changes were not evident in the other stroke severity groups.
Conclusion: This study emphasizes the importance of incorporating frailty assessments into premorbid evaluations, particularly when considering ADL outcomes in patients with mild stroke. Conversely, the significance of frailty in moderate-to-severe stroke was less evident.
(Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Aims: This study aimed to assess the impact of the premorbid mRS score and frailty on daily living (ADL) activities at hospital discharge, focusing on varying stroke severities.
Methods: This single-centre, prospective cohort study included patients with acute stroke aged ≥60 years. Key metrics included the frailty index for frailty assessment or mRS for functional status premorbid and the functional independence measure of the motor domain (FIM-M) at discharge for ADL outcomes. The patients were categorized into mild (0-4), moderate (5-15), and severe (16-42) groups based on the National Institute of Health Stroke Scale. Multiple hierarchical linear regression analyses were performed for each group to evaluate the influence of mRS and frailty on FIM-M scores.
Results: In the mild stroke group, significant associations were observed with premorbid mRS3 (β = -0.183, p = 0.004), mRS4 (β = -0.234, p < 0.001), and frailty status (β = -0.227, p = 0.005) and FIM-M scores. Premorbid frailty did not show a significant association with the FIM-M scores in the moderate or severe stroke group. Frailty status notably contributed to changes in R², particularly in the mild stroke group (R² change = 0.031, p = 0.002). However, such changes were not evident in the other stroke severity groups.
Conclusion: This study emphasizes the importance of incorporating frailty assessments into premorbid evaluations, particularly when considering ADL outcomes in patients with mild stroke. Conversely, the significance of frailty in moderate-to-severe stroke was less evident.
(Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)