Exploring the Relationship Between Pre-Stroke Frailty and Stroke Rehabilitation Outcomes: A Retrospective Study

Abstract Objective Stroke is a leading cause of long-term disability, often requiring inpatient rehabilitation. Frailty, characterized by reduced physiological reserve and vulnerability to stressors, is associated with poorer outcomes. This study examined the association between pre-stroke frailty and functional recovery during inpatient rehabilitation. Design Retrospective cohort study of 224 stroke patients admitted between 2020 and 2022; 206 were included in the analysis. Pre-stroke frailty was assessed using the Clinical Frailty Scale (CFS), and rehabilitation outcomes were measured using Functional Independence Measure (FIM) gain and efficiency. Associations were evaluated using Spearman correlations and linear regression. Results Of 206 patients, 42.7% were female and 75.7% were aged ≥60. FIM gain and efficiency did not differ significantly across CFS categories (p > 0.05). CFS was not correlated with FIM gain (r = –0.07, p = 0.316) or efficiency (r = 0.02, p = 0.755). Admission and discharge FIM scores differed across CFS categories (p = 0.041 and p = 0.002). Conclusion Although patients with higher pre-stroke frailty had lower functional scores at admission and discharge, functional improvement and efficiency did not differ significantly. However, the small number of patients with moderate to severe frailty (6.8%) may have limited the ability to detect a difference.