AUTHOR=Zedde Marialuisa , Lattanzi Simona , Pilotto Andrea , Janitschke Daniel , Stögbauer Jakob , Merzou Fatma , Pascarella Rosario , Padovani Alessandro , Morotti Andrea , Lochner Piergiorgio 

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

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1463814

DOI=10.3389/fneur.2024.1463814

ISSN=1664-2295

ABSTRACT=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.