Frailty is commonly observed in stroke patients and it is associated with adverse outcomes. However, there remains a gap in longitudinal studies investigating the causal relationship between baseline frailty and short-term prognosis in discharged adult stroke patients. To examine the causal impact of frailty on non-elective readmission and major adverse cardiac and cerebral events, and investigate its associations with cognitive impairment and post-stroke disability. A multicenter prospective cohort study. Two tertiary hospitals in Central and Northwest China. 667 adult stroke patients in stroke units were included from January 2022 to June 2022. Baseline frailty was assessed by the Frailty Scale. Custom-designed questions were utilized to assess non-elective readmission and major adverse cardiac and cerebral events as primary outcomes. Cognitive impairment, assessed using the Mini-Mental State Examination Scale (MMSE), and post-stroke disability, measured with the Modified Rankin Scale (mRS), were considered secondary outcomes at a 3-month follow-up. The impact of baseline frailty on non-elective readmission and major adverse cardiac and cerebral events was examined using bivariate and multiple Cox regression analyses. Furthermore, associations between baseline frailty and cognitive impairment, or post-stroke disability, were investigated through generalized linear models. A total of 5 participants died, 12 had major adverse cardiac and cerebral events, and 57 had non-selective readmission among 667 adult stroke patients. Frailty was an independent risk factor for non-selective readmission (hazard ratio [HR]: 2.71, 95 % confidence interval [CI]: 1.59, 4.62) and major adverse cardiac and cerebral events (HR: 3.77, 95 % CI: 1.07, 13.22) for stroke patients. Baseline frailty was correlated with cognitive impairment (regression coefficient [β]: −2.68, 95 % CI: −3.78, −1.58) adjusting for socio-demographic and clinical factors and follow-up interval. However, the relationship between frailty and cognitive impairment did not reach statistical significance when further adjusting for baseline MMSE (β: −0.39, 95 % CI: −1.43, 0.64). Moreover, baseline frailty was associated with post-stroke disability (β: 0.36, 95 % CI: 0.08, 0.65) adjusting for socio-demographic and clinical variables, follow-up interval, and baseline mRS. The finding highlights the importance of assessing baseline frailty in discharged adult stroke patients, as it is significantly associated with non-elective readmission, major adverse cardiac and cerebral events, and post-stroke disability at 3 months. These results highlight the crucial role of screening and evaluating frailty status in improving short-term prognosis for adult stroke patients. Interventions should be developed to address baseline frailty and mitigate the short-term prognosis of stroke. Baseline frailty predicts non-elective readmission, major adverse cardiac and cerebral events, and post-stroke disability in adult stroke patients. @haiyanhexyyy

中文翻译：

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虚弱对出院成人脑卒中患者短期预后的影响：一项多中心前瞻性队列研究


中风患者通常会出现虚弱症状，并且与不良后果相关。然而，在调查出院成年卒中患者基线虚弱与短期预后之间因果关系的纵向研究中仍存在空白。旨在检查衰弱对非选择性再入院和主要不良心脏和大脑事件的因果影响，并调查其与认知障碍和中风后残疾的关联。一项多中心前瞻性队列研究。华中和西北地区两家三级医院。 2022 年 1 月至 2022 年 6 月期间，纳入了卒中单元中的 667 名成年卒中患者。通过衰弱量表评估基线衰弱程度。使用定制设计的问题来评估非选择性再入院和主要不良心脏和大脑事件作为主要结局。使用简易精神状态检查量表 (MMSE) 评估的认知障碍和使用改良兰金量表 (mRS) 测量的中风后残疾，在 3 个月的随访中被视为次要结局。使用双变量和多重 Cox 回归分析检查基线虚弱对非选择性再入院和主要不良心脏和大脑事件的影响。此外，通过广义线性模型研究了基线虚弱与认知障碍或中风后残疾之间的关联。 667 名成年中风患者中，共有 5 名参与者死亡，12 名参与者出现重大心脏和脑部不良事件，57 名参与者非选择性再入院。虚弱是非选择性再入院的独立危险因素（风险比[HR]：2.71，95%置信区间[CI]：1.59，4.62）和主要不良心脑事件（HR：3.77，95% CI：1.07， 13.22）中风患者。 调整社会人口统计学和临床​​因素以及随访间隔后，基线虚弱与认知障碍相关（回归系数[β]：-2.68，95% CI：-3.78，-1.58）。然而，当进一步调整基线MMSE时，虚弱与认知障碍之间的关系并未达到统计学显着性（β：-0.39，95％CI：-1.43，0.64）。此外，根据社会人口统计和临床变量、随访间隔和基线 mRS 进行调整后，基线虚弱与中风后残疾相关（β：0.36，95% CI：0.08，0.65）。该发现强调了评估出院成人中风患者基线虚弱程度的重要性，因为它与非选择性再入院、主要不良心脏和大脑事件以及中风后 3 个月的残疾显着相关。这些结果凸显了筛查和评估虚弱状态在改善成年中风患者短期预后方面的关键作用。应制定干预措施来解决基线虚弱问题并减轻中风的短期预后。基线虚弱可预测成年中风患者的非选择性再入院、主要不良心脏和大脑事件以及中风后残疾。 @haiyanhexyyy