Background: Frailty is common in stroke, where it exerts disease- and treatment-modifying effects. However, there has been little work evaluating how frailty influences outcomes after percutaneous endoscopic gastrostomy (PEG) tube insertion. This study investigates the relationship between pre-stroke frailty and one-year mortality following PEG insertion.
Methods: A pre-stroke frailty index (FI) was calculated for individuals with post-stroke dysphagia who underwent PEG insertion between March 2019 and February 2021. Mortality was recorded at one year, as well as instances of post-PEG pneumonia and discharge destination.
Results: Twenty-nine individuals underwent PEG insertion, eleven (37.9%) of whom died in the subsequent year. The mean (SD) FI for those who survived was 0.10 (0.09), compared to 0.27 (0.19) for those who died ( = 0.02). This remained significant after adjustment for age and sex, with each 0.1 increase in the FI independently associated with an increased odds of one-year mortality (aOR 1.39, 95% CI 1.17-1.67). There was no association between frailty and post-PEG pneumonia (0.12 (0.21) in those who aspirated versus 0.11 (0.18) in those who did not, = 0.75).
Conclusions: Pre-stroke frailty is associated with increased one-year mortality after PEG, a finding that may help inform shared clinical decision-making in complex decisions regarding PEG feeding.
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http://dx.doi.org/10.3390/healthcare12161557 | DOI Listing |
Age Ageing
November 2024
Department of Clinical Neurosciences, University of Cambridge, R3 Clinical Neurosciences (Box 83) Addenbrooke's Hospital Hills Road, Cambridge CB2 0QQ, UK.
Background: Frailty-the loss of physiological reserve to withstand a stressor event-is associated with poorer outcomes following acute stroke reperfusion therapies. However, the mechanisms underlying this relationship are poorly understood. This study investigated the association between frailty and penumbral volumes in hyperacute ischemic stroke.
View Article and Find Full Text PDFNo Shinkei Geka
November 2024
Division of Neurology, Department of Medicine, Jichi Medical University.
Sarcopenia is a progressive skeletal muscle disorder involving an accelerated loss of muscle mass and function. Frailty is characterized by a decline in the functioning of multiple physiological systems and an increased vulnerability to stressors. The incidence of these pathological conditions increases with age and is often accompanied by various acute or chronic disorders.
View Article and Find Full Text PDFCerebrovasc Dis
November 2024
Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Introduction: The adequacy of blood flow from the leptomeningeal collaterals is considered one of the most important factors determining the rate of infarct progression and response to acute stroke treatments in the setting of large vessel occlusions. Several patient-related variables, including age, vascular risk factors, and laboratory parameters, have been proposed to explain the interindividual variability of collateral flow among stroke patients. This study aimed to assess how pre-stroke frailty, an aging-related syndrome characterized by a loss in the physiologic reserve of numerous body functions, affected the degree of leptomeningeal collateral flow in the setting of acute ischemic stroke.
View Article and Find Full Text PDFCerebrovasc Dis
October 2024
Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Introduction: Prognostication in spontaneous intracerebral hemorrhage (ICH) is vital for effective clinical decision-making but can be challenging. Frailty - the loss of physiological reserve to withstand stressor events - is a risk factor for poor outcomes after ischemic stroke, yet its role in ICH remains poorly understood. This study investigates whether frailty is independently associated with 28-day mortality following ICH.
View Article and Find Full Text PDFCerebrovasc Dis
September 2024
Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
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