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Association between Pre-stroke Frailty and Clinical Outcomes: A Systematic Review and Meta-analysis
Issei Murai1, Kensuke Matsuda2, Takashi Ariie2
1Department of Rehabilitation, Takagi Hospital, Japan.
Objective:
The relationship between pre-stroke frailty and clinical outcomes remains unclear. This systematic review aimed to examine the association of pre-stroke frailty with mortality, length of stay (LOS), and functional outcomes in people with stroke.
Methods:
We used several databases, including PubMed, EMBASE, and CENTRAL. We searched for studies investigating the association between pre-stroke frailty and clinical outcomes. The Quality in Prognosis Studies tool was used to assess the risk of bias in the included studies. Meta-analyses were performed using the random effects model. The certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation.
Results:
Fourteen studies (participants: 11583) were included in this review. Pre-stroke frailty is associated with higher mortality (odds ratio: 1.11; 95% confidence intervals [CI]: 1.0-1.23), longer LOS (mean difference: 0.75; 95% CI: -0.29 to 1.78), and poorer functional outcomes (standardized mean difference: 0.79; 95% CI: 0.48-1.1). The certainty of evidence is low due to risk of bias, inconsistency, and imprecision.
Conclusions:
These results suggest that frailty before stroke onset may be associated with higher mortality, increased LOS, and poorer functional outcomes.
