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This systematic review examined the association of pre-stroke frailty with mortality, length of stay (LOS), and functional outcomes in people with stroke. Methods: Searches of PubMed, EMBASE, and CENTRAL identified eligible studies. Risk of bias was assessed with the Quality in Prognosis Studies tool, and meta-analyses used a random-effects model. Certainty of evidence was evaluated using GRADE. Results: Fourteen studies (n=11,583) showed pre-stroke frailty was linked to higher mortality, longer LOS, and poorer functional outcomes; evidence certainty was low due to bias, inconsistency, and imprecision.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/association-between-pre-stroke-frailty-and-clinical-outcomes-a-systematic-review-and-meta-analysis/455156/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/association-between-pre-stroke-frailty-and-clinical-outcomes-a-systematic-review-and-meta-analysis/455156.png","ImageObject",300,407,{"name":92,"@type":93},"Rainbow Cat","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What outcomes were assessed in this systematic review?","Question",{"text":113,"@type":114},"The review assessed mortality, length of stay (LOS), and functional outcomes in people with stroke in relation to frailty before stroke onset.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which databases and methods were used to identify and synthesize studies?",{"text":118,"@type":114},"Studies were searched in PubMed, EMBASE, and CENTRAL, with study quality assessed using the Quality in Prognosis Studies tool. Meta-analyses used a random-effects model, and evidence certainty was graded with GRADE.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the results show about pre-stroke frailty?",{"text":122,"@type":114},"Across 14 studies, pre-stroke frailty was associated with higher mortality, longer LOS, and worse functional outcomes, but the certainty of evidence was low due to risk of bias, inconsistency, and imprecision.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},455156,1791032189,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46,"preview_page_count":4},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","P H Y S I C A LT H E R A P YR E S E A R C H  \nSystematic Review  \nAssociation between Pre-stroke Frailty and Clinical Outcomes: A Systematic Review and Meta-analysis  \nIssei MURAI, MSc, PT1, Kensuke MATSUDA, PhD, PT2, and Takashi ARIIE, PhD, PT2  \n1)Department of Rehabilitation, Takagi Hospital, Japan  \n2)Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Japan  \nABSTRACT. Objective: The relationship between pre-stroke frailty and clinical outcomes remains unclear.  \nThis systematic review aimed to examine the association of pre-stroke frailty with mortality, length of stay (LOS), and functional outcomes in people with stroke. Methods: We used several databases, including PubMed, EMBASE, and CENTRAL. We searched for studies investigating the association between pre-stroke frailty and clinical outcomes. The Quality in Prognosis Studies tool was used to assess the risk of bias in the included studies. Meta-analyses were performed using the random effects model. The certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation.  \nResults: Fourteen studies (participants: 11583) were included in this review. Pre-stroke frailty is associated with higher mortality (odds ratio: 1.11; 95% confidence intervals [CI]: 1.0–1.23), longer LOS (mean difference: 0.75; 95% CI: −0.29 to 1.78), and poorer functional outcomes (standardized mean difference: 0.79; 95%  \nCI: 0.48–1.1). The certainty of evidence is low due to risk of bias, inconsistency, and imprecision. Conclu  \nsions: These results suggest that frailty before stroke onset may be associated with higher mortality, increased LOS, and poorer functional outcomes.  \nKey words: Frailty, Stroke, Mortality, Length of stay, Functional outcomes  \n(Phys Ther Res 28: 231–238, 2025)  \nIntroduction  \nFrailty, a health condition prevalent among older individuals, has recently received increasing attention from the perspective of extending healthy life expectancy. The ADVANTAGE Joint Action of the World Health Organization and the European Union defines frailty as a progressive decline in physiological systems associated with aging1) . Frailty leads to reduced innate ability reserves, heightened vulnerability to stressors, and an increased risk of various  \nReceived: May 27, 2025  \nAccepted: July 2, 2025  \nAdvance Publication by J-STAGE: September 11, 2025  \nCorrespondence to: Takashi Ariie. Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, 137-1 Enokizu, Okawa, Fukuoka 831-8501, Japan  \ne-mail: [tks.ar1212@gmail.com](tks.ar1212@gmail.com)  \n[doi: 10.1298/ptr.25-E10357](doi: 10.1298/ptr.25-E10357)  \nThis work is licensed under a Creative Commons Attribution 4.0 International License.  \n©2025 Japanese Society of Physical Therapy  \nhealth complications2) . These vulnerabilities can cause health problems, including disability, loss of independence, and death, suggesting that frailty should be regarded as a multidimensional concept1) .  \nFrailty is associated with various disease outcomes. For example, frailty in people with cancer has adverse effects on postoperative complications, short-and long-term postoperative mortality, and length of stay (LOS)3) . Furthermore, an association between frailty and increased mortality has been reported in older people with heart failure4) . Therefore, identifying frailty in older people is essential for a comprehensive approach to addressing these disabling conditions5) . The prevalence rate of frailty before stroke onset was high (approximately 25%) in a previous systematic review6) . This rate is higher than that observed in community-dwelling older people, which is 7%–10%7) . However, the association between pre-stroke frailty and clinical outcomes remains unclear.  \nPredicting outcomes in people with acute stroke remains challenging8), and a better understanding of the association","cbCaihZjiJwrGskj","https://ap.wps.com/l/cbCaihZjiJwrGskj","pdf",1961809,"English","# Abstract\n# Introduction\n# Methods\n## Eligibility criteria","[{\"question\":\"What outcomes were assessed in this systematic review?\",\"answer\":\"The review assessed mortality, length of stay (LOS), and functional outcomes in people with stroke in relation to frailty before stroke onset.\"},{\"question\":\"Which databases and methods were used to identify and synthesize studies?\",\"answer\":\"Studies were searched in PubMed, EMBASE, and CENTRAL, with study quality assessed using the Quality in Prognosis Studies tool. Meta-analyses used a random-effects model, and evidence certainty was graded with GRADE.\"},{\"question\":\"What did the results show about pre-stroke frailty?\",\"answer\":\"Across 14 studies, pre-stroke frailty was associated with higher mortality, longer LOS, and worse functional outcomes, but the certainty of evidence was low due to risk of bias, inconsistency, and imprecision.\"}]","Association between Pre-stroke Frailty and Clinical Outcomes - A Systematic Review and Meta-analysis | PDF",1790742223]