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<p>Ischemic stroke (IS), particularly due to carotid artery stenosis (CAS), is a major global contributor to mortality and disability. Frailty, characterized by systemic physiological decline and reduced homeostatic reserves, has emerged as a powerful prognostic marker across a wide range of diseases. We aimed to evaluate the prognostic utility of a laboratory-based frailty index (FI-Lab) in patients with IS secondary to CAS (IS-CAS), focusing on short- and long-term mortality.&#xa0;Data were extracted from the MIMIC-IV database. FI-Lab was calculated using 33 routine tests within 24&#xa0;h of ICU admission. Patients were stratified into quartiles based on FI-Lab scores. Cox proportional hazards models, restricted cubic splines, Kaplan-Meier curves, and subgroup analyses were applied.&#xa0;Among 1,869 IS-CAS patients, higher FI-Lab scores were independently associated with increased 30-day and 1-year mortality (p for trend &lt; 0.001). The highest quartile had a significantly elevated hazard ratio compared to the lowest. Survival curves and RCS analyses supported a linear association. Subgroup analysis showed consistent trends, especially in patients not receiving mechanical ventilation.&#xa0;FI-Lab is a robust predictor of both short- and long-term mortality in IS-CAS. It holds promise for individualized risk stratification and could aid clinical decision-making in stroke management.</p>

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A laboratory-based frailty index predicts mortality in ischemic stroke with carotid artery stenosis: a retrospective analysis from the MIMIC-IV database

  • 期刊论文

  • 发表日期：

    2025年12月3日

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  • Muyuan Li,
  • Xiaoxin He,
  • Xuebing Feng,
  • Zhengyu Wang,
  • Shengyan Cui,
  • Lingyan Meng,
  • Xiaotian Wu,
  • Peng Gao

摘要

Ischemic stroke (IS), particularly due to carotid artery stenosis (CAS), is a major global contributor to mortality and disability. Frailty, characterized by systemic physiological decline and reduced homeostatic reserves, has emerged as a powerful prognostic marker across a wide range of diseases. We aimed to evaluate the prognostic utility of a laboratory-based frailty index (FI-Lab) in patients with IS secondary to CAS (IS-CAS), focusing on short- and long-term mortality. Data were extracted from the MIMIC-IV database. FI-Lab was calculated using 33 routine tests within 24 h of ICU admission. Patients were stratified into quartiles based on FI-Lab scores. Cox proportional hazards models, restricted cubic splines, Kaplan-Meier curves, and subgroup analyses were applied. Among 1,869 IS-CAS patients, higher FI-Lab scores were independently associated with increased 30-day and 1-year mortality (p for trend < 0.001). The highest quartile had a significantly elevated hazard ratio compared to the lowest. Survival curves and RCS analyses supported a linear association. Subgroup analysis showed consistent trends, especially in patients not receiving mechanical ventilation. FI-Lab is a robust predictor of both short- and long-term mortality in IS-CAS. It holds promise for individualized risk stratification and could aid clinical decision-making in stroke management.