Frailty and malnutrition predict poor outcomes in acute ischemic stroke patients

Komaki, R.; Oda, Tatsuya; Takata, Masaki; Endo, Hideki; Hosomi, Motonobu; Hamaguchi, Hirotoshi

doi:10.1016/j.jns.2017.08.2456

Cited by 2 publications

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“…Among the abstracts, four used a frailty index approach [ 29 , 30 , 38 , 39 ], three used the CFS [ 32 , 36 , 37 ], one used pre-stroke mRS [ 40 ], one used Fried phenotype criteria [ 33 ], one used comprehensive geriatric assessment (CGA [ 34 ]), one used the Canadian Study on Health and Ageing Scale [ 35 ] and one provided their own definition of frailty [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

Prevalence and implications of frailty in acute stroke: systematic review & meta-analysis

et al. 2022

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Background frailty is common in older adults and associated with poor outcomes following illness. Although stroke is predominantly a disease of older people, our knowledge of frailty in stroke is limited. We aimed to collate the literature on acute stroke and frailty to estimate the prevalence of pre-stroke frailty and its associations with outcomes. Methods paired researchers searched multidisciplinary electronic databases for papers describing frailty and acute stroke. We assessed risk of bias using Newcastle-Ottawa tools appropriate to study design. We created summary estimates of pre-stroke frailty using random effects models. We collated whether studies reported significant positive associations between frailty and clinical outcomes in adjusted models. Results we included 14 studies (n = 27,210 participants). Seven studies (n = 8,840) used a frailty index approach, four studies (n = 14,924) used Hospital Frailty Risk Scores. Pooled prevalence of pre-stroke frailty was 24.6% (95% confidence interval, CI: 16.2–33.1%; low quality evidence, downgraded due to heterogeneity, bias). Combining frailty and pre-frailty (nine studies, n = 23,827), prevalence of any frailty syndrome was 66.8% (95%CI: 49.9–83.7%). Seven studies were at risk of bias, from participant selection or method of frailty assessment. Pre-stroke frailty was associated with all adverse outcomes assessed, including longer-term mortality (positive association in 6 of 6 studies reporting this outcome; odds ratio: 3.75 [95%CI: 2.41–5.70]), length of admission (3 of 4 studies) and disability (4 of 6 studies). Conclusions despite substantial heterogeneity, whichever way it is measured, frailty is common in patients presenting with acute stroke and associated with poor outcomes. This has implications for the design of stroke services and pathways.

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Section: Resultsmentioning

confidence: 99%

Prevalence and implications of frailty in acute stroke: systematic review & meta-analysis

et al. 2022

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“…Komaki et al demonstrated that the frailty and fat mass measure as a method for evaluation of malnutrition may predict poor stroke related outcomes. Also, in younger groups, fat mass measure was a useful tool to predict poor outcomes in stroke patients [ 11 ]. In addition, previous studies illustrated that nutritional status at admission time may be associated with mortality and disability at discharge [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Also, in younger groups, fat mass measure was a useful tool to predict poor outcomes in stroke patients [ 11 ]. In addition, previous studies illustrated that nutritional status at admission time may be associated with mortality and disability at discharge [ 11 , 12 ]. In the current study, malnutrition is prevalent among stroke patients admitted to hospitals.…”

Section: Discussionmentioning

confidence: 99%

Subjective global assessment of malnutrition and dysphagia effect on the clinical and Para-clinical outcomes in elderly ischemic stroke patients: a community-based study

et al. 2021

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Background Malnutrition as a result of insufficient intake or uptake of nutrition leads to increasing rate of chronic diseases such as stroke. Stroke is one of the most common causes of death in western countries and its increasing trend has attracted lots of attention. In this regard, it seems logical to focus on modifiable risk factors such as nutrition, in order to reduce the resulting complications. Accordingly, this study aimed at evaluating nutrition status of stroke patients to estimate its relationship with clinical outcomes of stroke. Methods In the present cross-sectional study, 349 patients were recruited. Nutrition assessment was performed using Patient-Generated Subjective Global Assessment (PG-SGA). In addition, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and biochemical tests were performed. Results Our findings elucidated a significant positive correlation of mRS with PG-SGA and consciousness score, as well as a negative correlation with BMI, calf circumference, mid-arm circumference, and triceps skinfold at admission time (P ≤ 0.002). Moreover, a direct correlation was found between mRS and PG-SGA and consciousness score at discharge time (P ≤ 0.001). In contrast, an inverse correlation was established between mRS and mid-arm circumference (P = 0.02). Furthermore, univariate analysis indicated significant associations between mRS ≥ 3 and age (OR: 1.02; 95%CI: 1.00–1.04), PG-SGA (OR: 1.08; 95%CI: 1.03–1.13), NIHSS (OR: 1.04; 95%CI: 1.02–1.07), dysphagia (OR: 1.69; 95%CI: 1.03–2.77), consciousness (OR: 1.48; 95%CI: 1.07–2.04), and mid-arm circumference (OR: 0.95; 95%CI: 0.90–1.00). In addition, these associations remained significant in multivariate analysis for PG-SGA (OR: 1.07; 95%CI: 1.00–1.13) and NIHSS (OR: 1.04; 95%CI: 1.01–1.07). Conclusion This study revealed a positive correlation between mRS and consciousness status and PG-SGA score, as well as a negative one between mRS and MAC at discharge time.

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Frailty and malnutrition predict poor outcomes in acute ischemic stroke patients

Cited by 2 publications

References 0 publications

Prevalence and implications of frailty in acute stroke: systematic review & meta-analysis

Prevalence and implications of frailty in acute stroke: systematic review & meta-analysis

Subjective global assessment of malnutrition and dysphagia effect on the clinical and Para-clinical outcomes in elderly ischemic stroke patients: a community-based study

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