ArticleAge and ageing2024
Frailty reduces penumbral volumes and attenuates treatment response in hyperacute ischemic stroke.
Article in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treatment-modifying effects of frailty on stroke reperfusion therapy outcomes: a systematic review and meta-analysis.Age and ageing · 2026Pooled it
- Article
- The relationship between social frailty and self-care ability in elderly stroke patients: the mediating role of self-efficacy.Frontiers in psychology · 2026Article
- Frailty and Cardiovascular Risk.European cardiology · 2026Review
- Narrative Review on Post-Stroke Outcomes Through Recognition of Frailty, Sarcopenia, and Palliative Care Needs.Healthcare (Basel, Switzerland) · 2025Review
- Frailty and stroke: Global implications for assessment, research, and clinical care-A WSO scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Review
- Mediation Role of Behavioral Decision-Making Between Self-Efficacy and Self-Management Among Elderly Stroke Survivors in China: Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2025Article
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5 authors.
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Abstract
backgroundFrailty-the loss of physiological reserve to withstand a stressor event-is associated with poorer outcomes following acute stroke reperfusion therapies. However, the mechanisms underlying this relationship are poorly understood. This study investigated the association between frailty and penumbral volumes in hyperacute ischemic stroke.
methodsTotal ischemic lesion volumes (comprising infarct core and penumbral volumes) were measured using computed tomography (CT) perfusion imaging to give the penumbral fraction within the ischemic lesion. Pre-stroke frailty was measured using a validated frailty index. The relationship between frailty and penumbral fraction was adjusted for age, onset-to-CT interval, collateral scores, small vessel disease burden and vascular comorbidities. Stroke severity was measured using the National Institutes of Health Stroke Scale at baseline and after 24 h.
resultsIn 55 individuals receiving thrombolysis for ischemic stroke, increasing frailty was associated with a reduction in penumbral fraction (rs = -0.36, P < 0.01). This remained significant after adjustment for age, onset-to-imaging time and collateral score (beta = -1.16, P < 0.001). Correspondingly, frailty was independently negatively associated with proportional improvement in stroke severity following treatment (beta = -2.00, P < 0.01). C-reactive protein (CRP) on presentation was associated with frailty index (rs = 0.38, P < 0.01) and penumbral fraction (rs = -0.30, P = 0.02). DISCUSSION: A reduction in salvageable penumbra in frailty may explain the treatment-attenuating effects of frailty on reperfusion therapies. The association with CRP motivates further research into a possible inflammatory component of this relationship.
conclusionFrailty is independently associated with reduced penumbra and poorer neurological recovery in acute stroke. These findings may explain the attenuated response to stroke reperfusion therapies seen in frailer individuals.
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