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

Stroke is a leading cause of long-term disability, often requiring inpatient rehabilitation. Frailty, characterized by reduced physiological reserve and vulnerability to stressors, is associated with poorer outcomes. This study examined the association between prestroke frailty and functional recovery during inpatient rehabilitation.

Retrospective cohort study of 224 stroke patients admitted between 2020 and 2022; 206 were included in the analysis. Prestroke frailty was assessed using the Clinical Frailty Scale, and rehabilitation outcomes were measured using Functional Independence Measure gain and efficiency. Associations were evaluated using Spearman correlations and linear regression.

Of 206 patients, 42.7% were female and 75.7% were aged ≥60. Functional Independence Measure gain and efficiency did not differ significantly across Clinical Frailty Scale categories ( P  > 0.05). Clinical Frailty Scale was not correlated with Functional Independence Measure gain ( r  = -0.07, P  = 0.316) or efficiency ( r  = 0.02, P  = 0.755). Admission and discharge Functional Independence Measure scores differed across Clinical Frailty Scale categories ( P  = 0.041 and P  = 0.002).

Although patients with higher prestroke frailty had lower functional scores at admission and discharge, functional improvement and efficiency did not differ significantly. However, the small number of patients with moderate to severe frailty (6.8%) may have limited the ability to detect a difference.