Einfluss der Gebrechlichkeit beim geriatrischen Patienten auf den Erfolg der systemischen Lysetherapie beim ischämischen Schlaganfall
by Viviane Lea Gabriel
Date of Examination:2023-02-01
Date of issue:2023-01-20
Advisor:Prof. Dr. Jan Liman
Referee:Prof. Dr. Jan Liman
Referee:Prof. Dr. Christine von Arnim
Referee:Prof. Dr. Margarete Schön
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EnglishThe hospital frailty risk score (HFRS) was established to assess frailty in geriatric patients based on the tenth revision of the International Classification of Disease (ICD-10) code. Previous studies have shown that it can be used as a predictive value for adverse health outcomes in geriatric patients undergoing valvular surgery. This study aimed to establish the relationship between frailty, length of stay, and one-year mortality in patients with an ischemic stroke. Therefore, data of patients with an ischemic stroke undergoing systematic thrombolysis from 2014-2019 at the University Medical Center Göttingen was collected. The cohort was divided into two groups: patients older and younger than 65 years, to additionally analyze the impact of the HFRS on younger and more fit patients. They were then assigned to different risk groups measured by the HFRS: Low-Risk-Group (< 5 points), Intermediate-Risk-Group (5-15 points), and High-Risk-Group (> 15 points). Next, the groups were compared with already established prognostic markers such as the National Institutes of Health Stroke Scale (NIHSS) on adverse health outcomes such as developing pneumonia during the hospital stay or needing ventilation. In this cohort, High-Risk frailty patients had a significant higher NIHSS at admission and discharge. Moreover, the influence of frailty on one-year mortality of patients after ischemic stroke undergoing systematic thrombolysis was demonstrated. Frail and older patients had a significant higher mortality rate after one year than non-frail patients. However, despite current studies, no influence of frailty on the length of stay or hospital costs was found. In conclusion, the knowledge of frailty may aid in prognostication and clinical decision-making.
Keywords: HFRS; Frailty; systematic thrombolysis; Hospital Frailty Risk Score; stroke; ischemic stroke
Schlagwörter: HFRS; Schlaganfall; systemische Lyse