Prestroke Frailty and Functional Outcomes After Inpatient Stroke Rehabilitation: A Retrospective Cohort Study

Area of Science:

• Neurology
• Gerontology
• Rehabilitation Medicine

Background:

• Stroke is a primary cause of long-term disability, necessitating inpatient rehabilitation.
• Frailty, marked by diminished physiological reserve, predicts adverse outcomes in various health conditions.
• Pre-stroke frailty's impact on functional recovery post-stroke requires further investigation.

Purpose of the Study:

• To investigate the association between pre-stroke frailty and functional recovery during inpatient rehabilitation.
• To analyze how pre-stroke frailty, measured by the Clinical Frailty Scale (CFS), influences Functional Independence Measure (FIM) gain and efficiency.

Main Methods:

• Retrospective cohort study including 206 stroke patients (2020-2022).
• Pre-stroke frailty assessed using the Clinical Frailty Scale (CFS).
• Functional recovery measured by FIM gain and efficiency; analyzed using Spearman correlations and linear regression.

Main Results:

• No significant difference in FIM gain or efficiency was observed across different CFS frailty categories (p > 0.05).
• CFS scores showed no correlation with FIM gain (r = -0.07, p = 0.316) or efficiency (r = 0.02, p = 0.755).
• Significant differences in admission and discharge FIM scores were noted across CFS categories (p = 0.041 and p = 0.002, respectively).

Conclusions:

• While higher pre-stroke frailty correlated with lower admission/discharge functional scores, it did not significantly affect functional improvement or rehabilitation efficiency.
• The limited number of patients with moderate to severe frailty may have restricted the detection of potential differences.
• Further research with larger cohorts, particularly those including more frail individuals, is warranted.