Letters recovery after ischemic stroke. Sze et al showed that wors- We agree with the important limitations of self-reported ening frailty indices are strongly associated with worse out- measures that were mentioned by Sharma and Sivakumaran. comes in patients hospitalized with heart failure (a compa- However, the covariates we examined in this analysis were de- rable long-term disabling consequence of MI). rived not only from self-reporting, but also from interviews, Studies in the future could compare the difference in poste- clinical examinations, medical record abstraction, and pub- vent frailty between patients with ischemic stroke and MI. As- licly released Medicare claims data, as described in the article. sessing a patient’s premorbid frailty status using simple vali- Also, in the main models, we did not adjust for physical activ- dated frailty assessment tools could contribute to predicting ity or energy intake. The disability scales that were used in this how patients with ischemic stroke might perform in their sub- study and others that are considered standard to assess ac- sequent rehabilitation. It may even contribute to predicting tivities of daily living are assessed by self-reporting and have clinical outcomes earlier in the pathway when assessing pa- been shown to have
JAMA Neurology – American Medical Association
Published: Apr 26, 2018
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