Related Experiment Video
Updated: Jun 10, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Association between patient-reported frailty and nonhome discharge among older patients with acute stroke: A
Yanli Cui1,2, Cao Meng1, Lijun Xiang1
1Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Objective:
To investigate the association between prestroke frailty and nonhome discharge, prolonged length of stay as well as functional outcomes.
Design:
Prospective observational study.
Setting:
Single urban teaching hospital in Guangzhou, China.
Participants:
Consecutive sample of 271 older patients admitted with acute stroke.
Intervention:
N/A.
Main Measures:
A five-item FRAIL scale (0∼5 points) and the stroke severity at onset were measured. The primary outcome of interest was nonhome discharge, with secondary outcomes including prolonged length of stay and worse short-term prognosis. Multivariable logistic regression adjusting for confounding factors was used to determine the association between patient-reported frailty and nonhome discharge, prolonged length of stay, worse short-term prognosis.
Results:
The population had a median age of 68 [interquartile range (IQR), 64∼74)]years, with 50 individuals (18.5%) identified as frail. After adjusting for age, sex, Barthel index, National Institutes of Health Stroke Scale, and Mini-Mental Status Exam score at admission, patients with self-reported frailty were significantly likely to experience nonhome discharge (Odds Ratio [OR] = 4.788; 95% confidence interval [CI] = 1.272∼18.017; p = .021), prolonged length of stay (OR = 4.76; 95% CI = 1.80∼12.56; p = .002), mRS scores at 30 days (OR = 6.72;95% CI = 1.79∼25.20; p = .005) and three months postdischarge and three-month (OR = 8.94; 95% CI = 2.10∼38.08; p = .003).
Conclusions:
In older adults with stroke, frailty is associated with nonhome discharge, prolonged length of stay, and worse short-term prognosis, regardless of the stroke severity, cognition, and Barthel index score at admission. FRAIL scale can be used as a practical screening tool in acute care setting by multidisciplinary team in supporting discharge process.
