The association between frailty of older stroke patients during hospitalization and one-year all-cause mortality: A multicenter survey in China.
Xiao-Ming Zhang, Jing Jiao, Tao Xu and 1 others
PMID 35509704WHAT IT FOUND
Frailty assessed in hospital was linked to higher one-year mortality among 530 older stroke patients.
A five-item frailty screen may help nurses identify patients at higher mortality risk.
Key findings
01After adjustment for age, sex, ADL, IADL, education, falls, BMI, smoking, alcohol, low handgrip strength, polypharmacy and stroke type, frailty remained associated with one-year mortality (OR 3.38; 95% CI 1.22 to 9.37; P = 0.019).
02Frail patients had lower ADL and IADL independence scores than non-frail patients (ADL 61.89 versus 82.46; IADL 4.05 versus 6.55) and more one-year deaths (14 of 119 versus 13 of 411).
03Overall, 119 of 530 patients were frail and 27 died within one year (mortality 5.1%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
103 patients were lost to follow-up, so the analysed group may not represent all enrolled patients. Only 27 deaths occurred, and the adjusted confidence interval was wide (1.22 to 9.37). The study did not measure comorbidity, stroke severity, thrombolysis, surgery or other treatments, which could explain part of the association. There were only 37 hemorrhagic stroke patients and 493 ischemic stroke patients, so findings are dominated by ischemic stroke. The design was observational, so frailty was associated with mortality but not proven to cause it. The FRAIL scale was assessed by nurses within 48 hours, but the paper does not report how reliably the scale was measured in this sample.
Declared interests
Funded by Fundamental Research Funds for Central Universities of Peking Union Medical College (No. 3332020007). The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that frailty causes death or that screening improves survival. This was an observational cohort, it did not measure stroke severity, comorbidity, or treatments, and only 27 deaths occurred.