NYMC Faculty Publications
Frailty and Outcomes in Lacunar Stroke
Author Type(s)
Student, Resident/Fellow, Faculty
DOI
10.1016/j.jstrokecerebrovasdis.2022.106942
Journal Title
Journal of Stroke and Cerebrovascular Diseases
First Page
106942
Document Type
Article
Publication Date
2-1-2023
Department
Neurosurgery
Second Department
Neurology
Keywords
Frailty, Healthcare resource utilization, Lacunar stroke, Stroke outcomes
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND: Lacunar strokes (LS) are ischemic strokes of the small perforating arteries of deep gray and white matter of the brain. Frailty has been associated with greater mortality and attenuated response to treatment after stroke. However, the effect of frailty on patients with LS has not been previously described. OBJECTIVE: To analyze the association between frailty and outcomes in LS. METHODS: Patients with LS were selected from the National Inpatient Sample (NIS) 2016-2019 using the International Classification of Disease, 10 edition (ICD-10) diagnosis codes. The 11-point modified frailty scale (mFI-11) was used to group patients into severely frail and non-severely frail cohorts. Demographics, clinical characteristics, and complications were defined. Health care resource utilization (HRU) was evaluated by comparing total hospital charges and length of stay (LOS). Other outcomes studied were discharge disposition and inpatient death. RESULTS: Of 48,980 patients with LS, 10,830 (22.1%) were severely frail. Severely frail patients were more likely to be older, have comorbidities, and pertain to lower socioeconomic status categories. Severely frail patients with LS had worse clinical stroke severity and increased rates of complications such as urinary tract infection (UTI) and pneumonia (PNA). Additionally, severe frailty was associated with unfavorable outcomes and increased HRU. CONCLUSION: Severe frailty in LS patients is associated with higher rates of complications and increased HRU. Risk stratification based on frailty may allow for individualized treatments to help mitigate adverse outcomes in the setting of LS.
Recommended Citation
Vazquez, S., Stadlan, Z., Lapow, J. M., Feldstein, E., Shah, S., Das, A., Naftchi, A. F., Spirollari, E., Thaker, A., Kazim, S. F., Dominguez, J. F., Patel, N., Kurian, C., Chong, J., Mayer, S. A., Kaur, G., Gandhi, C. D., Bowers, C. A., & Al-Mufti, F. (2023). Frailty and Outcomes in Lacunar Stroke. Journal of Stroke and Cerebrovascular Diseases, 32 (2), 106942. https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106942
