Cerebrovascular Diseases最新文献

{"title":"Osteoporosis after stroke - retracted. Are all retractions the same? A short discussion on integrity of papers and researchers.","authors":"Stefano Carda, Marco Invernizzi","doi":"10.1159/000546595","DOIUrl":"https://doi.org/10.1159/000546595","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Quality of Stroke Services in Brazil Using the World Stroke Organization Roadmap.","authors":"Aline Palmeira Pires, Kelin Cristine Martin, Thaís L Secchi, Gisele Sampaio Silva, Letícia Costa Rebello, Daniel da Cruz Bezerra, Gabriel R de Freitas, Jamary Oliveira-Filho, Maramelia Miranda-Alves, Gustavo Wruck Kuster, Rodrigo Bazan, Marcos C Lange, João José Freitas de Carvalho, Francisco Jose Arruda Mont'Alverne, José Antonio Fiorot, Viviane F Zetola, Pedro S C Magalhães, Carlos Roberto M Rieder, Luiz Antonio Nasi, Raul Gomes Nogueira, Carla Cabral Moro, Leandro de Assis Barbosa, Wyllians Vendramini Borelli, Octávio Marques Pontes-Neto, Sheila Cristina Ouriques Martins","doi":"10.1159/000546276","DOIUrl":"https://doi.org/10.1159/000546276","url":null,"abstract":"<p><strong>Introduction: </strong>Organizing acute stroke care effectively reduces disability and mortality. Since the Ministry of Health in Brazil established the National Stroke Policy in 2012, stroke care has improved significantly. However, despite the increase in stroke centers, some hospitals have not fully implemented the recommended structure and protocols. This study aims to evaluate the quality of stroke services in Brazil based on the World Stroke Organization (WSO) Roadmap, marking the first step towards the Certification of Stroke Centers in Latin America.</p><p><strong>Method: </strong>From 2020 to 2022, we assessed the structure of stroke centers in Brazil via an online survey based on the WSO Roadmap. When multiple responses came from the same hospital, we checked for consistency and contacted the stroke center coordinator if needed. We then compared these findings to the structure of stroke centers available in 2008, before the national stroke plan began.</p><p><strong>Results: </strong>The number of stroke centers in Brazil increased from 35 in 2008 to 246 in 2022, with 216 centers assessed in this study (102 Essential, 114 Advanced). Advanced centers were mostly private (69%). Of all hospitals, 51% serve public health patients, 75% as Essential centers. The southeast and south region have the highest number of stroke centers (77%). All hospitals provided essential blood tests, CT scans, and thrombolytic therapy, with 97% having pre-hospital emergency services. Neurologists were available 24/7 in 85% of centers (49% on-call, 35% on duty, 16% via telemedicine), and 46% of hospitals had stroke units. Nearly 90% had acute neurosurgical care, and 47% offered endovascular thrombectomy 24/7. Advanced centers implemented 85% of the WSO Roadmap items, and Essential centers 76%. According to WSO/SIECV Certification, 39 centers were prepared for certification, and 18 were certified (6 private - Advanced, 12 public - 4 Advanced, 8 Essential).</p><p><strong>Conclusion: </strong>Brazil has significantly improved its stroke care structure, but disparities and areas for further enhancement remain, particularly in equity, resource access, and best practices implementation. Certification programs could help address these issues and improve outcomes for stroke patients.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Coexisting Obesity and Malnutrition and its Impact on Stroke and Brain structure: Insights from UK Biobank\".","authors":"Huicong Niu","doi":"10.1159/000546570","DOIUrl":"https://doi.org/10.1159/000546570","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Marital/Partner Status and Patient-reported Outcomes in Stroke Patients: A Systematic Review.","authors":"Cenjing Zhu, Phoebe M Tran, Erica C Leifheit, Erica S Spatz, Rachel P Dreyer, Kate Nyhan, Shi-Yi Wang, Patricia N E Roberson, Larry B Goldstein, Judith H Lichtman","doi":"10.1159/000546413","DOIUrl":"https://doi.org/10.1159/000546413","url":null,"abstract":"<p><strong>Background: </strong>The extent to which marital/partner status affects patient-reported outcome measures (PROMs) in stroke patients varies among reported studies. We conducted a systematic review and meta-analysis to clarify this relationship.</p><p><strong>Methods: </strong>Five databases (Medline, Web of Science, Scopus, EMBASE, and PsycINFO) were searched from inception to April 15, 2024. Peer-reviewed studies that reported the independent association of marital/partner status with defined PROMs for patients who had a stroke were eligible for inclusion. Results for eligible studies were classified into four pre-defined outcome domains (health-related quality of life [HRQoL], functional status, symptoms, and personal recovery outcomes). Study quality was appraised using the Newcastle-Ottawa Scale, and data were synthesized by outcome domains.</p><p><strong>Results: </strong>We identified 51 studies (n=552,943 participants), of which 10 were included in meta-analyses. Being married/partnered was associated with a lower likelihood of post-stroke depression (pooled OR, 0.62 [95%CI, 0.43 to 0.89], I2=0%) and anxiety (pooled OR, 0.32 [95%CI, 0.21 to 0.49], I2=0%) but was not associated with HRQoL (mixed and insignificant association in physical and mental domains). Qualitative synthesis further suggested that most studies supported better functional and personal recovery outcomes for stroke patients who were married/partnered compared with those who were unpartnered. Data were insufficient to determine whether the association of partner status varied by the sex of the stroke patient.</p><p><strong>Conclusions: </strong>Our findings highlight the importance of the influence of marital/partner status on PROMs among stroke patients for mental health, but not for HRQoL. Future research should aim to harmonize assessments and standardize reporting to enhance further investigation of these associations, determine whether there are differences by sex, and further explore the association between marital/partner status and poststroke functional outcomes.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-27"},"PeriodicalIF":2.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of neighbourhood deprivation with secondary prevention prescribing and all-cause mortality among stroke patients in Scotland: a population-based study.","authors":"Kadie-Ann Sterling, Melanie Turner, Peter Langhorne, Mary Joan Macleod","doi":"10.1159/000546261","DOIUrl":"https://doi.org/10.1159/000546261","url":null,"abstract":"<p><p>Background Previous studies have shown that residing in more deprived neighbourhoods is associated with an increased risk for stroke and worse health outcomes. We aim to investigate the association between neighbourhood deprivation and secondary prevention prescribing and all-cause mortality after a stroke in Scotland. Methods This retrospective observational study analysed linked data on first-ever stroke patients admitted to hospitals across Scotland between 1 January 2011 and 31 December 2018. Data were obtained from the Scottish Stroke Care Audit (SSCA), hospital admissions dataset, community prescribing and dispensing dataset, and mortality records. Neighbourhood deprivation was assessed using the Scottish Index of Multiple Deprivation (SIMD) quintiles. Study outcomes were one-year all-cause mortality and secondary prevention prescribing, stratified by stroke type and presence of atrial fibrillation (AF). Findings from Cox regression and logistic regression analyses, with models adjusted for sociodemographic factors, comorbidity burden, stroke severity and stroke unit admission, are presented. Results This study included 47 947 stroke patients, of which 11 752 (24.5%) resided in the most deprived areas and 7450 (15.6%) resided in the least deprived areas. Compared with patients from the most deprived areas, patients from the least deprived areas were older (78 (interquartile range (IQR) 68 - 84) vs 71 (60 - 81) years), experienced more intracerebral haemorrhages (12.1% vs 9.2%), and more AF (26.5% vs 20.4%). Among ischaemic stroke patients, residing in less deprived areas was associated with reduced hazard of all-cause mortality at one year (adjusted hazard ratio (aHR) 0.97; 95% confidence interval (CI), 0.96 - 0.99), reduced odds of antiplatelet prescription in patients without AF (adjusted odds ratio (aOR, 0.95; 95% CI, 0.92 - 0.98), and increased odds of being anticoagulated in patients with AF (aOR, 1.15; 95% CI, 1.09 - 1.20), compared to patients residing in the most deprived areas. No significant differences in all-cause mortality and secondary prevention prescribing by neighbourhood deprivation were found in intracerebral haemorrhage patients. Conclusion In this retrospective observational study, ischaemic stroke patients residing in the least deprived areas had a lower hazard of one-year all-cause mortality, lower odds of antiplatelet prescription (in the absence of AF), but higher odds of oral anticoagulant prescription (in the presence of AF), compared to those residing in the most deprived areas. These findings suggest that neighbourhood deprivation is independently associated with all-cause mortality and treatment after stroke, highlighting potential interventions for stroke risk factors and post-stroke care, particularly in patients from more deprived areas.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratifying the Utility of Transthoracic Echocardiography for Ischemic Stroke using a Risk Score.","authors":"Neel D Jani, Haley Basinger, Ann M Jones, Justin A Sattin, Aaron F Struck","doi":"10.1159/000544746","DOIUrl":"https://doi.org/10.1159/000544746","url":null,"abstract":"<p><strong>Introduction: </strong>Inpatient transthoracic echocardiography (TTE) is considered to be an important part of secondary prevention in acute ischemic stroke, but can be a barrier to discharge. The goal of the study is to generate a risk score to assess which patients will benefit from a TTE in the inpatient setting.</p><p><strong>Methods: </strong>The training data set consisted of all 874 patients from the UW Health Comprehensive Stroke Registry admitted for acute ischemic stroke / TIA from 2017 and 2018 that received a TTE. A validation data set of 200 stroke patients was used from the Indiana University Stroke Registry. Using the training data, a modified logistic regression model was developed with simplified coefficients and a limited number of variables. The area under the receiver operator characteristic curve (AUC) was compared between deferent models and between the training and validation data sets.</p><p><strong>Results: </strong>The training data consisted of 874 patients (52.9% male; median age 64 years). Validation data set consisted of 200 patients (53.5% male; median age, 64 years). For the final model, termed AL2OHA, mean AUC on the training data across five-fold cross validation was 0.78 (95% CI, 0.76 - 0.80). The model consisted of six variables, and one point was awarded for each: atrial fibrillation, large artery atherosclerosis, large vessel occlusion, obesity, prior anti-hypertensive medication usage and if patient's age was 18-39 or ≥ 70. Risk of positive findings was 6.2% for score of 0, 23.1% for score of 1, 57.4% for score of 2, 85.8% for score of 3, 96.4% for score of 4, and 99.2% for score of 5 or greater. When tested on the external validation data set, AUC was 0.73 and demonstrated to not be significantly different than the AUC for the training data set.</p><p><strong>Conclusions: </strong>The AL2OHA model is a clinical tool which can stratify which patients admitted for acute ischemic stroke/TIA are more likely to benefit from inpatient TTE's.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neglect after isolated thalamic stroke: a systematic review of the literature.","authors":"Ariane Dampfhoffer, Dario Cazzoli, Brigitte Charlotte Kaufmann, Thomas Nyffeler","doi":"10.1159/000545473","DOIUrl":"https://doi.org/10.1159/000545473","url":null,"abstract":"<p><strong>Background: </strong>Recent research has increasingly acknowledged the thalamus's role in the development of neuropsychological deficits, which were previously considered to be primarily related to cortical processes. Among these deficits, neglect is of particular importance in stroke survivors, as it is a predictor of poor functional outcome. This review aims to clarify the relationship between stroke lateralization and location within the thalamus and the occurrence of neglect.</p><p><strong>Methods: </strong>In the present study, we performed a systematic review according to the PRISMA guidelines. PubMed, Scopus, CINHAL and Web Of Science were searched for articles published from inception to June 30. 2024. All studies presenting cases of isolated vascular thalamic stroke (hemorrhagic, ischemic) and clinical neglect were included. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports, Case Series, and Case-Control Studies. We divided the thalamus into four parts (anterior, lateral, medial, and posterior) based on the four classical vascular territories, and performed a qualitative and a simple descriptive statistical analysis using absolute numbers and percentages of the data collected.</p><p><strong>Results: </strong>A total of 23 articles involving 37 patients were included: 31 cases (84%) with right-sided thalamic stroke and 6 cases (16%) with left-sided thalamic stroke. In the hemorrhagic stroke group (21 cases), there was a clear predominance of localization in the posterior (10 cases; 47%) and entire thalamus (9 cases; 43%), with no cases in the anterior part of the thalamus and only one case (5%) each in the medial and lateral parts. In contrast, ischemic cases were predominantly located in the anterior and lateral parts (6 cases each; 37.5%) with only 3 cases (19%) in the medial part and one case (6%) in the posterior part.</p><p><strong>Conclusion: </strong>Thalamic neglect appears to occur more frequently in right-sided thalamic strokes than in left-sided thalamic strokes. However, the exact neuroanatomical correlates differed between hemorrhagic and ischemic groups and the underlying mechanisms remain unclear due to the heterogeneity and paucity of data. Future studies should include a prospective design with standardized assessment of neglect and advanced brain imaging modalities.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-27"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-depth carotid calcification morphometrics and their temporal changes are associated with cardiovascular risk factors in patients with recent ischemic event: The Plaque at Risk (PARISK) Study.","authors":"Aikaterini Tziotziou, Federica Fontana, Suze-Anne Korteland, Kelly Nies, Paul Nederkoorn, Pim A de Jong, M Eline Kooi, Aad van der Lugt, Anton F W van der Steen, Jolanda J Wentzel, Daniel Bos, Ali C Akyildiz","doi":"10.1159/000546164","DOIUrl":"https://doi.org/10.1159/000546164","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke incidence varies significantly with respect to sex and cardiovascular risk factors (CVRF), a relationship that it is not well understood. Calcification in carotid atherosclerosis is known to impact plaque stability, potentially linked to ischemic stroke. The aim of this study was to assess the in-depth calcification morphometrics within extracranial carotid atherosclerosis, their temporal changes, and associations with sex and CVRF.</p><p><strong>Methods: </strong>Carotid arteries (n=144) with confirmed atherosclerosis and mild-to-moderate stenosis from 72 symptomatic patients (Plaque-At-Risk study) with recent ischemic event due to ischemia in the territory of a carotid artery were imaged using multi-detector computed tomography angiography (MDCTA) at baseline and after 2 years. The lumen, vessel wall, and calcifications were segmented semi-automatically and the carotid geometries were 3D reconstructed. A comprehensive morphometric assessment of carotid calcifications was performed on the baseline and follow-up scans. We investigated distributions of these metrics and their associations with sex and CVRF using Generalized Linear Mixed Models.</p><p><strong>Results: </strong>Our findings suggest that women have larger (4.5 mm2 (95%CI: 3.2-6.2) vs 3.2 mm2 (95%CI: 2.4-4.2)) calcifications, located closer to the lumen (0.6 mm (95%CI: 0.4-0.8) vs 0.9 mm (95%CI: 0.7-1.2)) compared to men at baseline and follow-up, adjusted for baseline measurements. At the baseline, non-smokers had larger (5.3 mm2 (95%CI: 3.7-7.5) vs 3.2 mm2 (95%CI: 2.3-4.4)), and longer (5.7 mm (95%CI: 4.1-7.3) vs 2.4 mm (95%CI: 1.6-3.6)) calcifications than the current smokers. Diabetic patients had thicker (1.1 mm (95%CI: 0.8-1.3) vs. 0.8 mm (95%CI: 0.7-0.9)) carotid calcifications at baseline.</p><p><strong>Conclusion: </strong>Our in-depth analyses exposed several geometric features of carotid calcifications associated with sex and CVRF, and provided further insight into the pathophysiology of carotid atherosclerosis.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and caregiver perspectives on the design and execution of ACT-GLOBAL, a stroke adaptive platform trial: a focus group study.","authors":"Aravind Ganesh, Nora D Cristall, Brian Dewar, Michael D Hill, Carol Kenney, Ivy A Sebastian, Rose Wilson, Craig S Anderson, Xiaoying Chen, Bijoy Menon, Michel C F Shamy, Nishita Singh","doi":"10.1159/000546132","DOIUrl":"https://doi.org/10.1159/000546132","url":null,"abstract":"<p><strong>Introduction: </strong>Adaptive platform trials represent a paradigm shift in stroke research. We examined how patient-partners perceived the design and execution of an international platform trial in acute stroke, ACT-GLOBAL (A multi-faCtorial, mulTi-arm, multi-staGe, randomised, gLOBal Adaptive pLatform trial for stroke), through a series of focus groups with process evaluation methodology.</p><p><strong>Methods: </strong>Participants were recruited from two comprehensive stroke centers one in Calgary, Canada and one in Sydney, Australia. Four virtual focus groups were attended by a total of 21 patient-partners and 11 clinician-researchers. One focus group had repeat attendees to review a draft consent form and patient information sheet, and one presented a video describing platform trials. Physician facilitators presented the platform trial concept followed by a facilitated discussion. Audio recordings were transcribed and combined with field notes. Exemplar quotes and themes were identified separately for each group and subsequently across groups.</p><p><strong>Results: </strong>Patients/caregivers perceived acute stroke-focussed adaptive platform trials such as ACT-GLOBAL as providing potentially beneficial opportunities to be randomized to multiple treatments, with efficiencies and richer data to improve patient care. Emphasis was given to the importance of gatekeeper processes for the addition of future questions posed by the platform to ensure examined questions would not interfere with routine care, and that safety decisions were ultimately made by non-conflicted parties. They appreciated that deferral of consent would be ideal to allow timely randomization/treatment within the adaptive stroke platform, and for patient safety to be prioritized in enrolment-related decisions with family input whenever feasible. The need to have trial information accessible in digestible chunks, multiple languages, and modalities, was emphasized. To facilitate engagement, transparency, trust, and two-way communication was deemed critical to the informed consent process.</p><p><strong>Conclusion: </strong>Patient-partners were supportive of an adaptive platform trial design. However, they expressed important priorities in their execution whilst safeguarding patient autonomy and safety. Oversight, multiple modes of delivering patient information, and having feedback evaluation and transparency with ongoing participation were identified as valued components. Deferral of consent was recognized as a pragmatic way to enrol patients. Similar considerations may apply to adaptive platform trials in other neurological/medical emergencies.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and associations of post-stroke frailty: a cross-sectional study.","authors":"Udaya K Ranawaka, Chamila Mettananda, Sithumi Liyanage, Nethra De Silva, Jayalath Chandrasiri, Harsha Dharmasena, Sajeewanie Fernando, Sujeewani Kurukulasuriya, Arunasalam Pathmeswaran","doi":"10.1159/000545884","DOIUrl":"https://doi.org/10.1159/000545884","url":null,"abstract":"<p><strong>Introduction: </strong>There is little data on stroke and frailty, especially from South Asia. We aimed to study the prevalence and associations of poststroke frailty in a cohort of stroke survivors.</p><p><strong>Methods: </strong>We studied all patients attending a tertiary care stroke clinic over one year (September 2023- August 2024). Patients with an index stroke event occurring one to five years earlier were included. Data on demographic features, stroke characteristics, functional outcome and frailty were studied. Frailty was assessed with the Rockwood Clinical Frailty Scale (CFS), stroke severity with the National Institute of Neurological Disorders and Stroke Scale (NIHSS) and functional status with the modified Rankin Scale (mRS). Frailty was defined by a CFS score of ≥5 and functional dependence by an mRS score of 3-5. Strokes were categorized as mild (NIHSS score of 1-4), moderate (5-14) or severe (>14). Associations of post-stroke frailty were studied using logistic regression.</p><p><strong>Results: </strong>A total of 143 patients with stroke (mean age 58 ±10 years, male 91 (63.6%)) with a mean follow-up of 2.7(±1.6) years were studied. Of them, 141 (98%) were functionally independent before stroke onset. The majority (115, ( 80.4%)) had ischaemic strokes, and 106 (74%) strokes were moderate to severe strokes (admission NIHSS ≥5). On follow-up, 47 patients (33%) were frail (CFS ≥5), with 13 patients (9.1%) having moderate to severe frailty (CFS 6-9). Functional dependence on follow-up was seen in 33 patients (23%). Post-stroke frailty was independently associated with increasing age (p= 0.012), diabetes (p=0.039) and admission stroke severity (p=0.001) on multivariable analysis. Biological sex, stroke type, other vascular risk factors and duration of follow-up were not associated with post-stroke frailty.</p><p><strong>Conclusions: </strong>This is the first report on post-stroke frailty in South Asia. One-third of stroke survivors were frail on follow-up. Older age, diabetes and stroke severity were independent predictors of post-stroke frailty.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}