Frailty and outcomes in lacunar stroke

Area of Science:

• Neurology
• Geriatrics
• Public Health

Background:

• Lacunar strokes (LS) affect small brain arteries, impacting deep gray and white matter.
• Frailty is known to increase mortality and reduce treatment effectiveness post-stroke.
• The specific impact of frailty on lacunar stroke outcomes remained undescribed.

Purpose of the Study:

• To investigate the association between frailty and patient outcomes following lacunar stroke.
• To identify how frailty influences clinical severity, complications, and healthcare resource utilization in LS patients.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database from 2016-2019.
• Identified LS patients using ICD-10 diagnosis codes.
• Assessed frailty using the 11-point modified frailty scale (mFI-11), categorizing patients into severely frail and non-severely frail groups.

Main Results:

• Out of 48,980 LS patients, 22.1% were severely frail.
• Severely frail patients were older, had more comorbidities, and lower socioeconomic status.
• Severe frailty correlated with worse stroke severity, increased complications (UTI, pneumonia), and higher healthcare resource utilization (total charges, length of stay).

Conclusions:

• Severe frailty significantly increases complication rates and healthcare resource utilization in lacunar stroke patients.
• Implementing frailty-based risk stratification could enable tailored treatments to improve LS patient outcomes.