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Abstract
Background: Frailty increases vulnerability to disease, poor functional outcomes, hospitalization and mortality in patients with acute illnesses or emergency surgery. However, the effect of frailty on outcomes of older patients with acute ischemic stroke has not been well studied in Vietnam. This study aims to determine the prevalence of frailty defined by the Canadian Clinical Frailty Scale and the association between frailty and mortality at 1 year in older patients with acute ischemic stroke.
Methods: A descriptive, cross - sectional and longitudinal study on all patients ≥ 60 years old diagnosed with acute ischemic stroke admitted to hospital and treated as inpatient at the Department of Cerebrovascular Diseases of 115 People’s Hospital, Ho Chi Minh City from June 2020 to March 2021.
Results: A total of 641 patients with acute ischemic stroke were included in the study. The mean age of the study population was 70.9 ± 8.2 (years), 43.8% were female, and the prevalence of frailty in the study population was 26.4%. The frail participants were older than the non - frail (mean age 78.7 ± 7.6 vs 68.1 ± 6.4, p < 0.001). Hypertension was the most common comorbidity (86%), followed by dyslipidemia (68.3%), and diabetes (25.4%). One - fifth of the study participants had a history of prior stroke and 11.2% had atrial fibrillation. At 12 months of follow - up, 12.3% of study participants died, and all - cause mortality at 12 months was significantly higher in the frail group compared with the non - frail group (30.8% vs 5.7%, p < 0.001). Multivariate analysis showed that frailty was an independent risk factor for mortality at 12 months (adjusted OR = 4.68, 95%CI 2.27 - 9.66, p < 0.001). In addition to frailty, age (adjusted OR = 1.05, 95%CI 1.01 - 1.10, p = 0.027 and NIHSS ≥ 15 (adjusted OR = 19.83, 95%CI 10.46 - 37.60, p < 0.001) were also independent risk factors for mortality.
Conclusion: Frailty was present in a quarter of the participants and was an independent predicting factor for all - cause mortality at 12 months in older patients with acute ischemic stroke. The study findings suggest early screening for frailty in older patients with acute ischemic stroke. Further studies are needed to examine the role of interventions on frailty to reduce mortality in older patients with acute ischemic stroke.
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| Published | 29-12-2024 | |
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| Issue | No. 80 (2022) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.80.1 | |
| Keywords | Suy yếu, đột quỵ thiếu máu não, cao tuổi, tử vong Frailty, ischemic stroke, elderly, mortality |
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