Is Frailty Index a better predictor than pre-stroke modified Rankin Scale for neurocognitive outcomes 3-months post-stroke?

BMC Geriatrics

Ragnhild Munthe-Kaas¹  Hege Ihle-Hansen²  Stian Lydersen³  Guri Hagberg⁴  Stina Aam⁵  Ingvild Saltvedt⁵  Torgeir Bruun Wyller⁶  Siri Rostoft⁶  Till Schellhorn⁷  Sarah T. Pendlebury⁸ 

[1] Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Neurology, Oslo University Hospital, Oslo, Norway;Department of Mental Health, Faculty of Medicine and Health Science, Regional Centre for Child and Youth Mental Health and Child Welfare, NTNU-Norwegian University of Science and Technology, Trondheim, Norway;Department of Neurology, Oslo University Hospital, Oslo, Norway;Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway;Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University Of Oxford, and the NIHR Biomedical Research Centre Oxford University Hospitals NHS Foundation Trust, Oxford, UK;Departments of Acute Internal Medicine and Geratology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK;

关键词: Stroke;    Cognition;    Cognitive Impairment;    Frailty;    Prediction;   

DOI  :  10.1186/s12877-022-02840-y

来源: Springer

【 摘 要 】

BackgroundThe prognostic value of frailty measures for post-stroke neurocognitive disorder (NCD) remains to be evaluated.AimsThe aim of this study was to compare the predictive value of pre-stroke FI with pre-stroke modified Rankin Scale (mRS) for post-stroke cognitive impairment. Further, we explored the added value of including FI in prediction models for cognitive prognosis post-stroke.MethodsWe generated a 36-item Frailty Index (FI), based on the Rockwood FI, to measure frailty based on pre-stroke medical conditions recorded in the Nor-COAST multicentre prospective study baseline assessments. Consecutive participants with a FI score and completed cognitive test battery at three months were included. We generated Odds Ratio (OR) with NCD as the dependent variable. The predictors of primary interest were pre-stroke frailty and mRS. We also measured the predictive values of mRS and FI by the area (AUC) under the receiver operating characteristic curve.Results598 participants (43.0% women, mean/SD age = 71.6/11.9, mean/SD education = 12.5/3.8, mean/SD pre-stroke mRS = 0.8/1.0, mean/SD GDS pre-stroke = 1.4/0.8, mean/SD NIHSS day 1 3/4), had a FI mean/SD score = 0.14/0.10. The logistic regression analyses showed that FI (OR 3.09), as well as the mRS (OR 2.21), were strong predictors of major NCD. When FI and mRS were entered as predictors simultaneously, the OR for mRS decreased relatively more than that for FI. AUC for NCD post-stroke was higher for FI than for mRS, both for major NCD (0.762 vs 0.677) and for any NCD (0.681 vs 0.638).ConclusionsFI is a stronger predictor of post-stroke NCD than pre-stroke mRS and could be a part of the prediction models for cognitive prognosis post-stroke.Trial RegistrationClinicalTrials.gov Identifier: NCT02650531.

【 授权许可】

CC BY