Association between pre-stroke frailty and post-discharge destination in acute stroke among Chinese older adults

Aims: To investigate the association between pre-stroke frailty and discharge destination in hospitalized older adults in China.

Methods: We conducted this prospective cohort study in a tertiary care hospital in China. We enrolled patients aged 60 years and older admitted to the hospital for acute stroke from January 2022 to May 2022. We used telephone tracking to record the destination of participants after discharge. Generalized estimating equations were used to determine the association between pre-stroke frailty and post-discharge destination.

Results: Among the 230 participants enrolled, the prevalence of pre-stroke frailty was 75.2% and about 75.7% of participants chose to go home at discharge. 70.5% of pre-stroke frail patients chose to go home, compared with 91.2% for non-pre-stroke frail patients. The generalized estimating equation showed a statistical difference between the frailty and non-frailty groups in the post-discharge destination of acute stroke patients between different time points (Waldχ² 36.428 and 13.893, P < 0.001 and 0.008, respectively). After adjustment for the group, the model showed an interaction effect of time and pre-stroke frail status on the post-discharge destination (P < 0.001). The results confirm the importance of pre-stroke frail status in predicting patients' post-discharge outcomes.

Conclusions: Pre-stroke frailty is related to the post-discharge destination and stroke prognosis in elderly Chinese. For Chinese families, most acute stroke patients choose to go home when they are discharged from the hospital, even those who are frail before acute stroke occurs. Further research is needed to confirm this finding and to actively intervene in the pre-stroke frail population.