Highlights
- •The PRISMA-7 questionnaire is a simple tool to diagnose frailty that can be easily applied in the context of acute stroke.
- •The predictive performance of the PRISMA-7 in acute stroke was similar to that of the Frailty Index and the NIHSS.
- •PRISMA-7 scores ≥ 3 were associated with an 89% probability of being disabled or dead 90 days after the stroke.
- •All participants with a PRISMA-7 score ≥ 3 and an NIHSS ≥ 16 were either disabled or dead 90 days after the stroke.
Abstract
Objectives
We aimed to evaluate the predictive performance of the PRISMA-7 frailty criteria regarding
the composite outcome of disability or death in patients with an acute ischemic stroke,
and to compare it with the Frailty Index and the National Institutes of Health Stroke
Scale (NIHSS).
Materials and methods
This prospective cohort study involved all patients aged ≥ 40 years admitted with
an acute ischemic stroke between March 2019 and January 2020. We performed survival
analyses, calculated risk ratios, sensitivity, specificity, and predictive values
for the combined outcome of disability or death according to the presence of frailty
as determined by the PRISMA-7 and the Frailty Index, and stroke severity based on
the NIHSS.
Results
In 174 patients with acute ischemic stroke, being frail in the week before the stroke
according to the PRISMA-7 was associated with a Risk Ratio of 4·50 (95%CI 1·77-11·43,
P <0·001) and a Positive Predictive Value of 89% (95%CI 77-99%) for being disabled
or dead 90 days after the stroke, and a Hazard Ratio of 3·33 (95%CI 1·48-7·51, P = 0·004)
for the survival outcome. The predictive performance of the PRISMA-7 was not significantly
different from the Frailty Index or the NIHSS.
Conclusions
We provide evidence that the PRISMA-7 frailty criteria may be a useful prognostication
tool in acute ischemic stroke.
Keywords
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Article info
Publication history
Published online: October 22, 2022
Accepted:
October 15,
2022
Received:
June 13,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106837
Copyright
© 2022 Elsevier Inc. All rights reserved.
