Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, July 16, 2020

CSHA Clinical Frailty Scale

It is YOUR DOCTOR'S RESPONSIBILITY to get you out of the lower scores in this post stroke.  YOUR DOCTOR'S RESPONSIBILITY!

CSHA Clinical Frailty Scale

 Kenneth Rockwood, Xiaowei Song, Chris MacKnight, Howard Bergman, David B. Hogan,
Ian McDowell, Arnold Mitnitski

Abstract

Background:
There is no single generally accepted clinical definition of frailty. Previously developed tools to assess frailty that
have been shown to be predictive of death or need for entry
into an institutional facility have not gained acceptance
among practising clinicians. We aimed to develop a tool that
would be both predictive and easy to use.
Methods:
We developed the 7-point Clinical Frailty Scale and applied it and other established tools that measure frailty to 2305
elderly patients who participated in the second stage of the
Canadian Study of Health and Aging (CSHA). We followed
this cohort prospectively; after 5 years, we determined the
ability of the Clinical Frailty Scale to predict death or need for
institutional care, and correlated the results with those obtained from other established tools.
Results: The CSHA Clinical Frailty Scale was highly correlated
(r = 0.80) with the Frailty Index. Each 1-category increment of
our scale significantly increased the medium-term risks of
death (21.2% within about 70 mo, 95% confidence interval
[CI] 12.5%–30.6%) and entry into an institution (23.9%, 95%
CI 8.8%–41.2%) in multivariable models that adjusted for age,
sex and education. Analyses of receiver operating characteristic curves showed that our Clinical Frailty Scale performed
better than measures of cognition, function or comorbidity in
assessing risk for death (area under the curve 0.77 for 18-
month and 0.70 for 70-month mortality).
Interpretation:
Frailty is a valid and clinically important construct
that is recognizable by physicians. Clinical judgments about
frailty can yield useful predictive information.

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