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BRIEF RESEARCH REPORT article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1463814

Premorbid frailty, stress hyperglycemia ratio and functional outcome in patients with acute ischemic stroke

Provisionally accepted
Marialuisa Zedde Marialuisa Zedde 1Simona Lattanzi Simona Lattanzi 2Andrea Pilotto Andrea Pilotto 3Daniel Janitschke Daniel Janitschke 4Jakob Stögbauer Jakob Stögbauer 4*Fatma Merzou Fatma Merzou 4Rosario Pascarella Rosario Pascarella 4ALESSANDRO PADOVANI ALESSANDRO PADOVANI 3Andrea Morotti Andrea Morotti 3Piergiorgio Lochner Piergiorgio Lochner 4
  • 1 Neurology Unit, Stroke Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
  • 2 Marche Polytechnic University, Ancona, Marche, Italy
  • 3 University of Brescia, Brescia, Lombardy, Italy
  • 4 Saarland University, Saarbrücken, Germany

The final, formatted version of the article will be published soon.

    Background: Frailty, defined as multidimensional prognostic index (MPI), has been recently identified as strong predictor of disability and mortality in the elderly with acute ischemic stroke (AIS). The stress hyperglycemia ratio (SHR) is a recently introduced biomarker significantly associated with poor outcome in AIS. Objectives: This study aimed to investigate in what extent frailty, measured by MPI, and SHR affects the 3-months outcome of AIS patients > 65 years-old. Methods: Consecutive patients with AIS >65 years-old who underwent intravenous thrombolysis (IVT) from 2015 to 2019 were enrolled in a German and an Italian Stroke Unit. The SHR was calculated by dividing the fasting plasma glucose at admission with glycated haemoglobin. Demographics and clinical premorbid data, stroke-related variables, including baseline and post-treatment NIHSS score were included in a logistic regression model. The 3-months functional outcome was evaluated by using modified Rankin scale (mRS); good outcome was defined as mRS 0-2, poor as mRS ≥ 3. Results: 155 AIS patients were enrolled in the study. Median MPI was 0.19 [0.13-0.31]; 118 (76.1%) patients were classified as “robust” and 37 (23.9%) as “frail”. In regression analysis, age, NIHSS and MPI demonstrated as the most significant predictor of 3-months good outcome in the whole cohort. In robust patients, SHR values were significantly associated with the outcome. Conclusions: MPI is associated with the 3-months outcome in our cohort, in particular with good outcome. Conversely, SHR seems to be associated with a 3-months poor outcome in “robust” patients but not in frail patients.

    Keywords: SHR, Frailty, Stroke, IVT, MPI

    Received: 12 Jul 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Zedde, Lattanzi, Pilotto, Janitschke, Stögbauer, Merzou, Pascarella, PADOVANI, Morotti and Lochner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jakob Stögbauer, Saarland University, Saarbrücken, Germany

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