Analysis of Frailty in Geriatric Patients as a Prognostic Factor in Endovascular Treated Patients with Large Vessel Occlusion Strokes.

elderly patients frailty hospital frailty risk score mechanical thrombectomy stroke

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
18 May 2021
Historique:
received: 10 03 2021
revised: 12 05 2021
accepted: 14 05 2021
entrez: 2 6 2021
pubmed: 3 6 2021
medline: 3 6 2021
Statut: epublish

Résumé

Frailty is associated with an increased risk of adverse health-care outcomes in elderly patients. The Hospital Frailty Risk Score (HFRS) has been developed and proven to be capable of identifying patients which are at high risk of adverse outcomes. We aimed to investigate whether frail patients also face adverse outcomes after experiencing an endovascular treated large vessel occlusion stroke (LVOS). In this retrospective observational cohort study, we analyzed patients ≥ 65 years that were admitted during 2015-2019 with LVOS and endovascular treatment. Primary outcomes were mortality and the modified Rankin Scale (mRS) after three months. Regression models were used to determine the impact of frailty. A total of 318 patients were included in the cohort. The median HFRS was 1.6 (IQR 4.8). A total of 238 (75.1%) patients fulfilled the criteria for a low-frailty risk with a HFRS < 5.72 (22.7%) for moderate-frailty risk with an HFRS from 5-15 and 7 (2.2%) patients for a high-frailty risk. Multivariate regression analyses revealed that the HFRS was associated with an increased mortality after 90 days (CI (95%) 1.001 to 1.236; OR 1.112) and a worse mRS (CI (95%) 1.004 to 1.270; OR 1.129). We identified frailty as an impact factor on functional outcome and mortality in patients undergoing thrombectomy in LVOS.

Identifiants

pubmed: 34069797
pii: jcm10102171
doi: 10.3390/jcm10102171
pmc: PMC8157268
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Neurosurgery. 2020 Jun 15;:
pubmed: 32542353
Front Neurol. 2019 Nov 29;10:1255
pubmed: 31849819
Can J Neurol Sci. 2021 Mar 09;:1-6
pubmed: 33685540
Age Ageing. 2020 Jul 1;49(4):588-591
pubmed: 31951248
JAMA. 2016 Sep 27;316(12):1279-88
pubmed: 27673305
J Am Heart Assoc. 2020 Mar 3;9(5):e014447
pubmed: 32089059
Stroke. 2019 Nov;50(11):3164-3169
pubmed: 31922464
BMJ Open. 2019 Jan 15;9(1):e026923
pubmed: 30647051
Med Care. 2016 Feb;54(2):188-94
pubmed: 26683778
Am J Cardiol. 2020 May 1;125(9):1317-1323
pubmed: 32147090
Int J Cardiol. 2020 Feb 1;300:184-190
pubmed: 31699454
Stroke. 2003 Aug;34(8):1925-31
pubmed: 12843342
Eur Heart J. 2019 Jul 14;40(27):2231-2239
pubmed: 30977798
Stroke. 2017 Jul;48(7):1818-1826
pubmed: 28526765
Lancet. 2013 Mar 2;381(9868):752-62
pubmed: 23395245
JAMA Cardiol. 2019 Nov 1;4(11):1084-1091
pubmed: 31553402
Eur Radiol. 2016 Nov;26(11):4213-4219
pubmed: 26905866
Neurology. 2014 Jan 28;82(4):340-50
pubmed: 24363134
BMJ Qual Saf. 2019 Apr;28(4):284-288
pubmed: 30381331
Lancet. 2013 Apr 13;381(9874):1312-22
pubmed: 23541057
Lancet. 2016 Apr 23;387(10029):1723-31
pubmed: 26898852
Med Care. 2017 Jul;55(7):698-705
pubmed: 28498196
Lancet. 2018 May 5;391(10132):1775-1782
pubmed: 29706364
Age Ageing. 2017 Sep 1;46(5):801-806
pubmed: 28531254

Auteurs

Marlena Schnieder (M)

Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany.

Mathias Bähr (M)

Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany.

Mareike Kirsch (M)

Department of Geriatrics, University Medical Center Göttingen, 37073 Göttingen, Germany.

Ilko Maier (I)

Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany.

Daniel Behme (D)

Department of Neuroradiology, University Hospital of Magdeburg, 39120 Magdeburg, Germany.

Christian Heiner Riedel (CH)

Department of Neuroradiology, University Medical Center Göttingen, 37073 Göttingen, Germany.

Marios-Nikos Psychogios (MN)

Department of Interventional and Diagnostical Neuroradiology, Clinic for Radiology and Nuclearmedicine, University Hospital Basel, 4031 Basel, Switzerland.

Alex Brehm (A)

Department of Interventional and Diagnostical Neuroradiology, Clinic for Radiology and Nuclearmedicine, University Hospital Basel, 4031 Basel, Switzerland.

Jan Liman (J)

Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany.

Christine A F von Arnim (CAF)

Department of Geriatrics, University Medical Center Göttingen, 37073 Göttingen, Germany.

Classifications MeSH